Healthcare Provider Details

I. General information

NPI: 1467372979
Provider Name (Legal Business Name): CHANEL MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHANEL BLANCHET

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7975 LAKE UNDERHILL RD STE 300345
ORLANDO FL
32822-8202
US

IV. Provider business mailing address

6957 KELCHER CT
ORLANDO FL
32807-5096
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-8626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number32802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: