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Individual

DR. CARMEN E. MORALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5005 PORT ST JOHN PKWY STE 2500, PORT ST JOHN, FL 32927-4305
(321) 504-0556
(321) 504-0773
Mailing address
250 HARRISON STREET, PHN OFFICE, TITUSVILLE, FL 32780
(321) 504-0556
(321) 504-0773

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME54747
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000620700
FL
Enumeration date
08/08/2006
Last updated
10/02/2020
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