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NPI Code Detail

MEDICARE: JOSE MANUEL MORALES LOPEZ ARNP

MEDICARE: JOSE MANUEL MORALES LOPEZ ARNP
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
1363LF0000XFamily Nurse Practitioner11014288FL

Other Identifiers

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

General Provider Information

NPI Number : 1811569064
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE MANUEL MORALES LOPEZ ARNP
Provider Business Mailing Address
First Line : 6821 SOUTHPOINT DR N STE 107
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-8026
Country : US
Telephone Number : 866-372-0308
Fax Number : 877-460-4651
Provider Business Practice Location Address
First Line : 6607 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-3985
Country : US
Telephone Number : 813-499-1500
Fax Number : 813-499-1499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2021
Last Update Date : 10/05/2021

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