MEDICARE: ENRIQUE A MORATO

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	363A00000X	Physician Assistant	PA9107370	FL

General Provider Information

NPI Number	:	1972936698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENRIQUE A MORATO

Provider Business Mailing Address
First Line	:	4430 SW 129TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4009
Country	:	US
Telephone Number	:	786-317-8416
Fax Number	:

Provider Business Practice Location Address
First Line	:	14100 SW 136TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-5506
Country	:	US
Telephone Number	:	862-044-6007
Fax Number	:

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

Provider Enumeration Date	:	08/16/2013
Last Update Date	:	08/06/2019

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Directions to “ ENRIQUE A MORATO ” Practice Location

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