Provider Demographics
NPI:1518174234
Name:MORALES, RICARDO RAUL (AP)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:RAUL
Last Name:MORALES
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 SWIFT RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-6578
Mailing Address - Country:US
Mailing Address - Phone:941-924-4400
Mailing Address - Fax:941-924-4404
Practice Address - Street 1:4001 SWIFT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6578
Practice Address - Country:US
Practice Address - Phone:941-924-4400
Practice Address - Fax:941-924-4404
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1869171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP1869OtherACUPUNCTURE PHYSICIAN