Individual
LUZ ANTONELA MORALES REQUENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13200 MCCORMICK DR STE E-1, TAMPA, FL 33626-3010
(813) 814-5971
Mailing address
1113 TUSCANNY ST, BRANDON, FL 33511-6180
(813) 814-5971
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/25/2025
Last updated
07/25/2025
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