Healthcare Provider Details

I. General information

NPI: 1851847172
Provider Name (Legal Business Name): EDUARDO MORALES RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14911 SW 80TH ST APT 217
MIAMI FL
33193-3150
US

IV. Provider business mailing address

14911 SW 80 ST APT 217
MIAMI FL
33193
US

V. Phone/Fax

Practice location:
  • Phone: 786-308-0342
  • Fax:
Mailing address:
  • Phone: 786-308-0342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberCNA-212196
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-16-12777
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: