Healthcare Provider Details

I. General information

NPI: 1508563693
Provider Name (Legal Business Name): ANGELITA L MORALES MA, RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 HOLLYWOOD BLVD STE 715S
HOLLYWOOD FL
33021-6755
US

IV. Provider business mailing address

2806 NE 8TH TER
OCALA FL
34470-3688
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax:
Mailing address:
  • Phone: 352-497-3201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH22268
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH24853
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: