MEDICARE: LYNETT MORALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS49727	FL

General Provider Information

NPI Number	:	1023613940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNETT MORALES

Provider Business Mailing Address
First Line	:	11960 NW 11TH ST
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-4367
Country	:	US
Telephone Number	:	305-338-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	775 W 49TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3645
Country	:	US
Telephone Number	:	305-823-0823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2020
Last Update Date	:	11/30/2020

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Directions to “ LYNETT MORALES ” Practice Location

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