Provider Demographics
NPI:1275115511
Name:MORALES ZAMORA, RAQUEL ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:ELIZABETH
Last Name:MORALES ZAMORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 SW 22ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3941
Mailing Address - Country:US
Mailing Address - Phone:305-450-8913
Mailing Address - Fax:
Practice Address - Street 1:1414 SW 22ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3941
Practice Address - Country:US
Practice Address - Phone:305-450-8913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB617545103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst