Provider Demographics
NPI:1538620463
Name:MORALES, CARMEN (ARNP)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20753 SW 128TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5518
Mailing Address - Country:US
Mailing Address - Phone:305-397-4283
Mailing Address - Fax:
Practice Address - Street 1:12803 SW 280TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8552
Practice Address - Country:US
Practice Address - Phone:786-504-3022
Practice Address - Fax:786-504-3092
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001856363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty