Individual
ALICIA R. MORNEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
417A RACETRACK RD NW, SUITE 2, FORT WALTON BEACH, FL 32547-4600
(850) 863-5990
(850) 862-0041
Mailing address
417A RACETRACK RD NW, SUITE 2, FORT WALTON BEACH, FL 32547-4600
(850) 863-5990
(850) 862-0041
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291883800
—
FL
Enumeration date
03/14/2006
Last updated
01/04/2016
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