Provider Demographics
NPI:1548468556
Name:MORALES, JUAN CARLOS (AP1773)
Entity type:Individual
Prefix:MR
First Name:JUAN
Middle Name:CARLOS
Last Name:MORALES
Suffix:
Gender:M
Credentials:AP1773
Other - Prefix:
Other - First Name:JUAN
Other - Middle Name:CARLOS
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2901 E IRLO BRONSON HWY
Mailing Address - Street 2:SUITE C.
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5600
Mailing Address - Country:US
Mailing Address - Phone:407-344-5500
Mailing Address - Fax:407-344-5503
Practice Address - Street 1:2901 E IRLO BRONSON HWY
Practice Address - Street 2:SUITE C.
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5600
Practice Address - Country:US
Practice Address - Phone:407-344-5500
Practice Address - Fax:407-344-5503
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1773171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist