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General NPI Number Information
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NPI Number | 1386466753
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Entity Type | Individual
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Provider Name | BRIAN ABEL MORALES PEREZ
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Gender | Male
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3300 S UNIVERSITY DR
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City | FT LAUDERDALE
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State | FL
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Zip | 33328-2004
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Country | US
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Telephone | 800-541-6682
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Fax |
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Provider Business Mailing Address
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Address Line | 2890 SW 73RD WAY APT 1316
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City | DAVIE
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State | FL
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Zip | 33314-1018
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Country | US
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Telephone | 939-339-1997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | PSI47479
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License Number State | FL
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