Healthcare Provider Details

I. General information

NPI: 1649638024
Provider Name (Legal Business Name): YANITZA MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 NW 42ND AVE SUITE 500
MIAMI FL
33126-5473
US

IV. Provider business mailing address

164 E 59TH ST
HIALEAH FL
33013-1252
US

V. Phone/Fax

Practice location:
  • Phone: 305-643-7800
  • Fax:
Mailing address:
  • Phone: 305-824-0415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: