Individual
MR. KODY DYLAN SACKS-MOYNIHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20900 BISCAYNE BLVD, AVENTURA, FL 33180-1495
(305) 682-2483
(305) 682-5250
Mailing address
20900 BISCAYNE BLVD, AVENTURA, FL 33180-1407
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A183930
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2020
Last updated
06/15/2023
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