Provider Demographics
NPI:1023029477
Name:MORAES, MICHELE J (MD, PA)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:J
Last Name:MORAES
Suffix:
Gender:F
Credentials:MD, PA
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Mailing Address - Street 1:9325 GLADES RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3988
Mailing Address - Country:US
Mailing Address - Phone:561-883-7770
Mailing Address - Fax:561-883-7779
Practice Address - Street 1:9325 GLADES RD
Practice Address - Street 2:SUITE 107
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3988
Practice Address - Country:US
Practice Address - Phone:561-883-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME75276207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL29435OtherNEIGHBORHOOD HEALTH PARTNERSHIP
FL0385357OtherUNITED HEALTHCARE
FL070015557OtherRAILROAD MEDICARE
FL5401815OtherCCN
FL5828675OtherAETNA
FL3653936001OtherCIGNA
FL42933OtherBLUE CROSS BLUE SHIELD
FL6016198OtherGHI
FL248180OtherAVMED
FL248180OtherAVMED
FL070015557OtherRAILROAD MEDICARE