MEDICARE: JOSE E VILLASUSO MORALES FNP

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	363LF0000X	Family Nurse Practitioner	11036762	FL

General Provider Information

NPI Number	:	1831906056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE E VILLASUSO MORALES FNP

Provider Business Mailing Address
First Line	:	20120 SKOKIE DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2122
Country	:	US
Telephone Number	:	786-306-2387
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 E 25TH ST STE 214
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3850
Country	:	US
Telephone Number	:	786-755-4815
Fax Number	:	786-755-4821

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

Provider Enumeration Date	:	12/11/2024
Last Update Date	:	03/10/2026

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