Healthcare Provider Details

I. General information

NPI: 1023974326
Provider Name (Legal Business Name): SYNDIA MARIE SANTANA MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BROWN BEAR CT
SAINT CLOUD FL
34772-7046
US

IV. Provider business mailing address

680 BROWN BEAR CT
SAINT CLOUD FL
34772-7046
US

V. Phone/Fax

Practice location:
  • Phone: 407-613-7656
  • Fax:
Mailing address:
  • Phone: 407-613-7656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number11049895
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9556233
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: