Individual
DANIEL ALFONSO MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2734 SW 37TH AVE, COCONUT GROVE, FL 33133-2728
(305) 642-4263
Mailing address
2734 SW 37TH AVE, COCONUT GROVE, FL 33133-2728
(786) 355-4818
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9113632
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7863554818
—
FL
Enumeration date
09/13/2020
Last updated
11/23/2021
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