MEDICARE: DR. SANDRA D. MORALES MD

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	208000000X	Pediatrics Physician	ME68743	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538128228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA D. MORALES MD

Provider Business Mailing Address
First Line	:	12780 WATERFORD LAKES PKWY STE 135
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-4501
Country	:	US
Telephone Number	:	407-380-5888
Fax Number	:	407-384-1136

Provider Business Practice Location Address
First Line	:	12780 WATERFORD LAKES PKWY STE 135
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-4501
Country	:	US
Telephone Number	:	407-380-5888
Fax Number	:	407-384-1136

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	07/09/2020

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Directions to “ DR. SANDRA D. MORALES MD” Practice Location

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