Provider Demographics
NPI:1174260848
Name:MORALES, BRENDA (APRN)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15060 SW 149TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4416
Mailing Address - Country:US
Mailing Address - Phone:786-205-1506
Mailing Address - Fax:
Practice Address - Street 1:806 S DOUGLAS RD STE 101
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3157
Practice Address - Country:US
Practice Address - Phone:305-223-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018248363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily