Basic Information
| Provider Information | |||||||||
| NPI: | 1780937771 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLEOD-MOYA | ||||||||
| FirstName: | CATHERINE | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1071 35TH AVE | ||||||||
| Address2: | |||||||||
| City: | VERO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329604049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059045175 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6601 S.W. 80 ST SUITE 107 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056688644 | ||||||||
| FaxNumber: | 3056686010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2012 | ||||||||
| LastUpdateDate: | 04/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 163W00000X | 9465710 | FL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.