MEDICARE: DR. ERNESTO ALBERTO EUSEBIO MORALES M.D.

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	207RS0012X	Sleep Medicine (Internal Medicine) Physician	4301085516	MI
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	ME131908	FL
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	04-36985	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	003719300	OTHER		MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1760685531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNESTO ALBERTO EUSEBIO MORALES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-343-0762
Fax Number	:	239-343-0958

Provider Business Practice Location Address
First Line	:	23421 WALDEN CENTER DR STE 100
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	34134-4911
Country	:	US
Telephone Number	:	239-788-6500
Fax Number	:	239-776-2720

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	09/09/2024

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