Healthcare Provider Details

I. General information

NPI: 1851302251
Provider Name (Legal Business Name): OSMIN A MORALES M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US

IV. Provider business mailing address

PO BOX 558427
MIAMI FL
33255-8427
US

V. Phone/Fax

Practice location:
  • Phone: 305-663-3014
  • Fax: 305-661-2959
Mailing address:
  • Phone: 305-663-3014
  • Fax: 305-661-2959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: OSMIN A MORALES
Title or Position: OWNER
Credential: MD
Phone: 305-663-3014