MEDICARE: KARLA MORILLO MANON APRN

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	363LA2100X	Acute Care Nurse Practitioner	11032783	FL

General Provider Information

NPI Number	:	1790534154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA MORILLO MANON APRN

Provider Business Mailing Address
First Line	:	9333 SW 152ND ST
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-1778
Country	:	US
Telephone Number	:	305-243-5512
Fax Number	:	305-243-4613

Provider Business Practice Location Address
First Line	:	9333 SW 152ND ST
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-1778
Country	:	US
Telephone Number	:	305-243-5512
Fax Number	:	305-243-4613

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

Provider Enumeration Date	:	05/16/2024
Last Update Date	:	12/09/2025

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