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General NPI Number Information
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NPI Number | 1548790413
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Entity Type | Individual
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Provider Name | LUZ PATRICIA MORALES GONZALEZ MD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 3240 S FLORIDA AVE STE 101
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City | LAKELAND
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State | FL
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Zip | 33803-4574
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Country | US
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Telephone | 863-644-7337
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Fax |
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 321-332-6947
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Fax | 407-286-4515
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 14284-I
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1149
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License Number State | FL
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