Healthcare Provider Details
I. General information
NPI: 1013448596
Provider Name (Legal Business Name): DANIEL MORALES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/25/2017
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9981 S HEALTHPARK DR
FORT MYERS FL
33908-3618
US
IV. Provider business mailing address
630 14TH ST SE
NAPLES FL
34117-3695
US
V. Phone/Fax
- Phone: 239-343-2052
- Fax: 239-343-5348
- Phone: 786-725-8799
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | ME145277 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME145277 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: