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General NPI Number Information
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NPI Number | 1831906056
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Entity Type | Individual
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Provider Name | JOSE E VILLASUSO MORALES FNP
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Gender | Male
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 777 E 25TH ST STE 214
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City | HIALEAH
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State | FL
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Zip | 33013-3850
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Country | US
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Telephone | 786-755-4815
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Fax | 786-755-4821
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Provider Business Mailing Address
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Address Line | 20120 SKOKIE DR
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City | HIALEAH
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State | FL
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Zip | 33015-2122
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Country | US
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Telephone | 786-306-2387
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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 | 11036762
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License Number State | FL
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