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NPI Code Detail

MEDICARE: LOURDES MORENO MORALES

MEDICARE:   LOURDES  MORENO 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
1101Y00000XCounselor

General Provider Information

NPI Number : 1356056493
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOURDES MORENO MORALES
Provider Business Mailing Address
First Line : 18340 MEDITERRANEAN BLVD APT 2808
Second Line :
City : HIALEAH
State : FL
Zip : 33015-5734
Country : US
Telephone Number : 754-257-0204
Fax Number :
Provider Business Practice Location Address
First Line : 18340 MEDITERRANEAN BLVD APT 2808
Second Line :
City : HIALEAH
State : FL
Zip : 33015-5734
Country : US
Telephone Number : 754-257-0204
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2023
Last Update Date : 01/23/2023

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Directions to “ LOURDES MORENO MORALES ” Practice Location

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