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NPI Code Detail

MEDICARE: RAYMOND BENITO MORALES PT

MEDICARE:   RAYMOND BENITO MORALES  PT
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
1225100000XPhysical Therapist23040MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123040OTHERMDMARYLAND BOARD OF PHYSICAL THERAPY

General Provider Information

NPI Number : 1255964722
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMOND BENITO MORALES PT
Provider Business Mailing Address
First Line : 11901 GEORGIA AVE
Second Line :
City : WHEATON
State : MD
Zip : 20902-2001
Country : US
Telephone Number : 301-942-2500
Fax Number :
Provider Business Practice Location Address
First Line : 11901 GEORGIA AVE
Second Line :
City : WHEATON
State : MD
Zip : 20902-2001
Country : US
Telephone Number : 301-942-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2020
Last Update Date : 02/12/2020

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Directions to “ RAYMOND BENITO MORALES PT” Practice Location

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