Healthcare Provider Details

I. General information

NPI: 1336788124
Provider Name (Legal Business Name): DARLING COLINA MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2019
Last Update Date: 12/27/2019
Certification Date: 12/27/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 TAMIAMI TRL N STE B
NAPLES FL
34103-2853
US

IV. Provider business mailing address

5050 TAMIAMI TRL N STE B
NAPLES FL
34103-2853
US

V. Phone/Fax

Practice location:
  • Phone: 239-351-0675
  • Fax: 239-631-5295
Mailing address:
  • Phone: 239-351-0675
  • Fax: 239-631-5295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-102479
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: