MEDICARE: MORESA CULBREATH

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	103T00000X	Psychologist	SS1309	FL
2	103TS0200X	School Psychologist	SS1309	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306131529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORESA CULBREATH

Provider Business Mailing Address
First Line	:	1601 PARK CENTER DR STE 14
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5700
Country	:	US
Telephone Number	:	321-320-8472
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 PARK CENTER DR STE 14
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5700
Country	:	US
Telephone Number	:	321-320-8472
Fax Number	:	407-209-0329

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

Provider Enumeration Date	:	06/15/2011
Last Update Date	:	06/18/2026

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Directions to “ MORESA CULBREATH ” Practice Location

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