Provider Demographics
NPI:1477785145
Name:MORALES, FABIAN VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:FABIAN
Middle Name:VICTOR
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5966 S DIXIE HWY STE 401
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5177
Mailing Address - Country:US
Mailing Address - Phone:786-453-2667
Mailing Address - Fax:
Practice Address - Street 1:5966 S DIXIE HWY STE 401
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5177
Practice Address - Country:US
Practice Address - Phone:786-453-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120474204C00000X
NY254381-1207PS0010X
NJ25MA08828600207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine