Healthcare Provider Details

I. General information

NPI: 1568032225
Provider Name (Legal Business Name): RAYMOND CARLO MORALES JR. CRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9318 NEW HERITAGE RD APT 106
ORLANDO FL
32825-3784
US

IV. Provider business mailing address

9318 NEW HERITAGE RD APT 106
ORLANDO FL
32825-3784
US

V. Phone/Fax

Practice location:
  • Phone: 347-441-9087
  • Fax:
Mailing address:
  • Phone: 347-441-9087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number4984
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT15936
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: