Healthcare Provider Details

I. General information

NPI: 1730011990
Provider Name (Legal Business Name): ELIZABETH MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14055 TOWN LOOP BLVD STE 300
ORLANDO FL
32837-6106
US

IV. Provider business mailing address

1136 CROSSTOWN WAY UNIT 5210
ORLANDO FL
32807-8396
US

V. Phone/Fax

Practice location:
  • Phone: 407-857-6285
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI8803
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: