Provider Demographics
NPI:1376880369
Name:MORALES, ALEXIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 PORTOFINO WAY
Mailing Address - Street 2:APT 204
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-8182
Mailing Address - Country:US
Mailing Address - Phone:561-596-7305
Mailing Address - Fax:
Practice Address - Street 1:1910 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4228
Practice Address - Country:US
Practice Address - Phone:561-533-6885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist