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General NPI Number Information
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NPI Number | 1821763707
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Entity Type | Individual
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Provider Name | RAISA VALDES MORALES
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Gender | Female
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 9250 NW 36TH ST STE 420
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City | DORAL
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State | FL
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Zip | 33178-2775
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Country | US
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Telephone | 305-266-2929
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Fax |
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Provider Business Mailing Address
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Address Line | 8500 SW 109TH AVE APT 214
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City | MIAMI
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State | FL
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Zip | 33173-4458
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Country | US
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Telephone | 786-516-7046
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11014274
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License Number State | FL
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