Healthcare Provider Details

I. General information

NPI: 1306339734
Provider Name (Legal Business Name): BRITTNEY MORALES OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 4008
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE ML 4008
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4751
  • Fax: 513-636-7911
Mailing address:
  • Phone: 513-636-4751
  • Fax: 513-636-7911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number0618002652
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.006803
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: