Healthcare Provider Details

I. General information

NPI: 1437950458
Provider Name (Legal Business Name): JOHNNATAN MORALES GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15924 SW 92ND AVE
PALMETTO BAY FL
33157-1842
US

IV. Provider business mailing address

3760 BIRD RD UNIT 729
MIAMI FL
33146-1562
US

V. Phone/Fax

Practice location:
  • Phone: 305-964-5824
  • Fax: 786-452-1200
Mailing address:
  • Phone: 305-724-2652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: