Healthcare Provider Details

I. General information

NPI: 1578210639
Provider Name (Legal Business Name): HANS MORALES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103400 OVERSEAS HWY STE 240
KEY LARGO FL
33037-2849
US

IV. Provider business mailing address

12411 SW 113TH LN
MIAMI FL
33186-4945
US

V. Phone/Fax

Practice location:
  • Phone: 305-998-4248
  • Fax:
Mailing address:
  • Phone: 786-380-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: