Provider Demographics
NPI:1235520628
Name:MORALES, BONNIE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 CROSSWINDS DR N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-5471
Mailing Address - Country:US
Mailing Address - Phone:727-548-8500
Mailing Address - Fax:727-501-7328
Practice Address - Street 1:6735 CROSSWINDS DR N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-5471
Practice Address - Country:US
Practice Address - Phone:727-548-8500
Practice Address - Fax:727-501-7328
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-06
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR853387363LF0000X
TN19625363LF0000X
FLAPRN11016405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily