| Moyenda Medical Associates | |
|
220 S Dixie Hwy Ste 4 Lake Worth FL 33460-4153 | |
| (954) 774-1414 | |
| Not Available |
| Full Name | Moyenda Medical Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 220 S Dixie Hwy Ste 4, Lake Worth, Florida |
| Authorized Official Name and Position | Zakiya Bomani Moyenda (OWNER) |
| Authorized Official Contact | 9547741414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moyenda Medical Associates 10276 Oak Meadow Ln Ste 1a Lake Worth FL 33449-5467 Ph: (954) 774-1414 | Moyenda Medical Associates 220 S Dixie Hwy Ste 4 Lake Worth FL 33460-4153 Ph: (954) 774-1414 |
| NPI Number | 1104313816 |
|---|---|
| Provider Enumeration Date | 04/18/2018 |
| Last Update Date | 04/19/2023 |
| Medicare PECOS PAC ID | 6002249422 |
|---|---|
| Medicare Enrollment ID | O20191125002510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104313816 | NPI | - | NPPES |
| 015182600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME121227 (Florida) | Primary |
| Provider Name | Zakiya Moyenda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073878138 PECOS PAC ID: 0143537563 Enrollment ID: I20150917001823 |
| Provider Name | Jimmy Dorival |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114372596 PECOS PAC ID: 2062893597 Enrollment ID: I20220715000026 |
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