Provider Demographics
NPI:1093260440
Name:MORALES, JENNIFER (R N)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6152 SW 4TH PL
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-1667
Mailing Address - Country:US
Mailing Address - Phone:786-286-7116
Mailing Address - Fax:
Practice Address - Street 1:6152 SW 4TH PL
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33068-1667
Practice Address - Country:US
Practice Address - Phone:786-286-7116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9349682163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN 9349682OtherFLORIDA BOARD OF NURSING