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NPI Code Detail

MEDICARE: DATMEY MORALES GONZALEZ

MEDICARE:   DATMEY  MORALES GONZALEZ
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1942049341
Entity Type Code : Individual
Provider Name (Legal Business Name) : DATMEY MORALES GONZALEZ
Provider Business Mailing Address
First Line : 7210 NW 174TH TER APT 204
Second Line :
City : HIALEAH
State : FL
Zip : 33015-7263
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7210 NW 174TH TER APT 204
Second Line :
City : HIALEAH
State : FL
Zip : 33015-7263
Country : US
Telephone Number : 786-921-2179
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2024
Last Update Date : 05/23/2024

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Directions to “ DATMEY MORALES GONZALEZ ” Practice Location

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