Healthcare Provider Details

I. General information

NPI: 1659293330
Provider Name (Legal Business Name): KELSEY MORALES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 NATURE WALK PKWY
SAINT AUGUSTINE FL
32092-5073
US

IV. Provider business mailing address

19 NATURELAND CIR
SAINT AUGUSTINE FL
32092-3305
US

V. Phone/Fax

Practice location:
  • Phone: 904-328-7489
  • Fax:
Mailing address:
  • Phone: 413-275-8159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT24801
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: