MEDICARE: SANDRA MORALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA98118	FL

General Provider Information

NPI Number	:	1013639731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA MORALES

Provider Business Mailing Address
First Line	:	3868 NE 169TH ST APT 301
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3209
Country	:	US
Telephone Number	:	305-409-6656
Fax Number	:

Provider Business Practice Location Address
First Line	:	3868 NE 169TH ST APT 301
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3209
Country	:	US
Telephone Number	:	305-409-6656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	09/19/2022

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Directions to “ SANDRA MORALES ” Practice Location

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