Provider Demographics
NPI:1184856171
Name:MORALES, MADELINE (APRN)
Entity Type:Individual
Prefix:
First Name:MADELINE
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 1:2415 N ORANGE AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5521
Mailing Address - Country:US
Mailing Address - Phone:407-303-2474
Mailing Address - Fax:407-303-0680
Practice Address - Street 1:2910 WOOLRIDGE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-9069
Practice Address - Country:US
Practice Address - Phone:407-303-2474
Practice Address - Fax:407-303-0680
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9172934363LF0000X
FL9172934363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001369100Medicaid
CI847ZMedicare Oscar/Certification