Moonshine Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MOONSHINE ALF LLC

Practice address

19240 SW 124TH CT
Miami, FL 33177-6500

Phone

(305) 278-7314

Fax

(786) 244-5787

NPI assigned

Apr 4, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Armando Fandino Espinosa

Title

Owner

Phone

(786) 691-6809

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1386349710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19240 SW 124TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331776500",
            "telephone_number": "305-278-7314",
            "fax_number": "786-244-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19240 SW 124TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331776500",
            "telephone_number": "305-278-7314",
            "fax_number": "786-244-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONSHINE ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "FANDINO ESPINOSA",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-691-6809"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "9350",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moon River Alf
• Seo Yoon Moon, M.D.
• Moona Medical Group PA
• Sachin Moonat, M.D., PH.D.
• Zide Mooni
• Vivian Yvette Moore-Gaudette, PMHC
• Alexa Taylor Moore, PA-C
• Amanda Campbell Moore, DDS
• Ana Moore
• Angela Courtney Moore, ARNP

• Assisted Living Facility in Miami, FL
• Providers in Miami, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.