Healthcare Provider Details

I. General information

NPI: 1205292182
Provider Name (Legal Business Name): ALEKSANDRS MOROZOVS APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 311
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

PO BOX 70280
PHILADELPHIA PA
19176-0280
US

V. Phone/Fax

Practice location:
  • Phone: 561-434-0353
  • Fax:
Mailing address:
  • Phone: 561-434-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11035652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: