La'Quesha Tequila Moore, PHARMD.
Individual provider Active NPI Pharmacist · Miami Gardens, FL
NPI 1003192071 · NPPES record last updated Oct 22, 2011
Key facts
- NPI
- 1003192071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS45843 (FL)
- Practice address
- 18300 NW 37TH Ave
Miami Gardens, FL 33056-5101 - Phone
- (305) 626-9469
- Fax
- (305) 626-9329
- NPI assigned
- Oct 22, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS45843 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS45843 | FL | Yes |
Addresses
Primary practice location
18300 NW 37TH Ave
Miami Gardens, FL 33056-5101
Mailing address
18300 NW 37TH Ave
Miami Gardens, FL 33056-5101
Phone (305) 626-9469
Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.