Provider Demographics
NPI:1730863978
Name:ABREU MORALES, MARSIOL
Entity type:Individual
Prefix:
First Name:MARSIOL
Middle Name:
Last Name:ABREU MORALES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 BITTERNUT WAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-9514
Mailing Address - Country:US
Mailing Address - Phone:346-855-3953
Mailing Address - Fax:
Practice Address - Street 1:2360 BITTERNUT WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-9514
Practice Address - Country:US
Practice Address - Phone:346-855-3953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX805075986343900000X
FLL25000111621343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)