| Doctor Name: | LISA MOYER |
| NPI Number: | 1114306321 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, CRNP |
| License Number: | SP014529 |
| Business Practice Address: | 1787 Sentry Pkwy W Bldg 16 Suite 405 Blue Bell, PA - 194222239 |
| Business Phone Number: | 8778684827 |
| Business Fax Number: | 8772830663 |
| Mailing Address: | 123 Se 3rd Ave, Suite 460 MIAMI |
| State: | FL |
| Postal Code: | 331312003 |
| Phone Number: | 8778684827 |
| Fax Number: | 8772830663 |
| NPI Enumeration Date: | 05/20/2015 |
| NPI Last Update Date: | 06/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | SP014529 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |