Individual
AIDA MOISEEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
5989 NW 74TH ST, PARKLAND, FL 33067-2450
(347) 524-7802
Mailing address
5989 NW 74TH ST, PARKLAND, FL 33067-2450
(347) 524-7802
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
Primary
1429615
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T221-400-81-567-0
ITDS
FL
Enumeration date
06/09/2017
Last updated
02/19/2025
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