Healthcare Provider Details

I. General information

NPI: 1619083359
Provider Name (Legal Business Name): MARIELY MORALES-MURRAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIELY MORALES MD

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N PARK AVE SUITE 106
APOPKA FL
32712-3634
US

IV. Provider business mailing address

515 N PARK AVE SUITE 106
APOPKA FL
32712-3634
US

V. Phone/Fax

Practice location:
  • Phone: 407-814-4934
  • Fax: 407-814-4936
Mailing address:
  • Phone: 407-814-4934
  • Fax: 407-814-4936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME86243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: