Individual
MRS. LATAIYA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 AVENUE Q, FORT PIERCE, FL 34947-5600
(772) 209-2825
Mailing address
3801 AVENUE Q, FORT PIERCE, FL 34947-5600
(772) 209-2825
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
09/16/2019
Last updated
09/18/2019
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