Provider Demographics
NPI:1134666290
Name:MORALES, ROBERTO NICOLAS (APRN)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:NICOLAS
Last Name:MORALES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 E OSCEOLA PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1616
Mailing Address - Country:US
Mailing Address - Phone:321-841-6444
Mailing Address - Fax:407-370-5820
Practice Address - Street 1:1001 E OSCEOLA PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1616
Practice Address - Country:US
Practice Address - Phone:321-841-6444
Practice Address - Fax:407-370-0582
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008736363LA2200X
FLAPRN1108736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health