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Stephanie R. Moss

General Acute Care Hospital

Hospitals

1611 NW 12th Ave, Central 766 (D39), Miami, FL 33136-1005

PECOS Enrollment

This provider is enrolled in PECOS as STEPHANIE MOSS.

Based on the most recent information from CMS, provider Stephanie R. Moss is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 15 days ago.

Profile Details

Provider ID
1154342426
Provider Type
Individual
Full Name
Moss, Stephanie R.
Credential
NP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/22/2006
Last Updated
7/8/2007

Contact Information

Practice Location

1611 NW 12th Ave, Central 766 (D39), Miami, FL 33136-1005

(305) 585-5535

(305) 585-8109

Mailing Location

9915 NW 20th St, Pembroke Pines, FL 33024-1443

(954) 443-3055

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 282N00000X Primary	Description General Acute Care Hospital Hospitals	License 2159342 Florida

Provider Identifiers

ID	Description	Issuer
ID 2159342	Description Other	Issuer ARNP LICENSE NUMBER Florida

Stephanie R. Moss

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Miami Va Health Care System

Public Health Trust Of Miami Dade County Florida

Jackson Memorial Hospital

Jackson Mem Hos

University Of Miami

Public Health Trust Of Miami Dade County Florida

Cedars Healthcare Group, Ltd.

Jackson Memorial Hospital

University Of Miami

Anne Bates Leach Eye Hospital