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General NPI Number Information
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NPI Number | 1528190642
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Entity Type | Individual
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Provider Name | VICTOR HUGO MORA LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 1800 W 49TH ST SUITE 324-0
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City | HIALEAH
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State | FL
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Zip | 33012-2900
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Country | US
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Telephone | 305-825-3872
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Fax | 305-825-3873
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Provider Business Mailing Address
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Address Line | 7872 NW 201ST TER
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City | HIALEAH
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State | FL
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Zip | 33015-5997
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Country | US
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Telephone | 305-303-3236
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6661
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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