Healthcare Provider Details

I. General information

NPI: 1598620627
Provider Name (Legal Business Name): GABRIELLA ISABEL MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 SW 118TH TER
DAVIE FL
33330-1600
US

IV. Provider business mailing address

4169 SW 153RD AVE
MIRAMAR FL
33027-3378
US

V. Phone/Fax

Practice location:
  • Phone: 754-779-7888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT26741
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: