Individual
SOPHIA ANTRANIKA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12461 SW 190TH TER, MIAMI, FL 33177-3833
(954) 696-5078
Mailing address
12461 SW 190TH TER, MIAMI, FL 33177-3833
(195) 469-6507
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FS925051
COSMETOLOGY
FL
Enumeration date
07/02/2022
Last updated
02/26/2024
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