Provider Demographics
NPI:1194055335
Name:MOISE, MYRTHA (RRT)
Entity type:Individual
Prefix:
First Name:MYRTHA
Middle Name:
Last Name:MOISE
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 NW 101ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-1421
Mailing Address - Country:US
Mailing Address - Phone:305-759-0072
Mailing Address - Fax:954-404-6053
Practice Address - Street 1:688 NW 101ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-1421
Practice Address - Country:US
Practice Address - Phone:305-759-0072
Practice Address - Fax:954-404-6053
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT104012279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health