Healthcare Provider Details

I. General information

NPI: 1982977260
Provider Name (Legal Business Name): EVELYN N MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 05/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7873 BROCKWOOD CIR
ORLANDO FL
32822-7877
US

IV. Provider business mailing address

7873 BROCKWOOD CIR
ORLANDO FL
32822-7877
US

V. Phone/Fax

Practice location:
  • Phone: 407-967-9970
  • Fax:
Mailing address:
  • Phone: 407-967-9970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: