Provider Demographics
NPI:1154391407
Name:MOYA-HUFF, FERNANDO ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:ANTONIO
Last Name:MOYA-HUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100905
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1228 S PINE ISLAND RD STE 310
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4583
Practice Address - Country:US
Practice Address - Phone:954-392-1725
Practice Address - Fax:954-837-1113
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75432207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002876700OtherGROUP MEDICAID
FL002610900Medicaid
FL002876700OtherGROUP MEDICAID
200042269OtherMEDICARE RAILROAD RETIREMENT
E4002YMedicare PIN
200042269OtherMEDICARE RAILROAD RETIREMENT
K0493OtherGROUP MEDICARE PTAN