Healthcare Provider Details

I. General information

NPI: 1730630872
Provider Name (Legal Business Name): EMILY MORALES SPEECH THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 SW 56TH ST STE C
MIAMI FL
33165-6559
US

IV. Provider business mailing address

10130 SW 45TH ST
MIAMI FL
33165-5011
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-0188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA17879
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: