Healthcare Provider Details

I. General information

NPI: 1750731659
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL MORALES B.A., BCABA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 FRIDAY RD
COCOA FL
32926-3409
US

IV. Provider business mailing address

1865 FRIDAY RD
COCOA FL
32926-3409
US

V. Phone/Fax

Practice location:
  • Phone: 321-888-3021
  • Fax:
Mailing address:
  • Phone: 866-255-1279
  • Fax: 661-263-4584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-16-7081
License Number StateFL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier018246300
Identifier TypeMEDICAID
Identifier StateFL
Identifier IssuerFlorida Medicaid Provider ID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: