Provider Demographics
NPI:1609987635
Name:MORALES, OFILIO J (DMD)
Entity Type:Individual
Prefix:DR
First Name:OFILIO
Middle Name:J
Last Name:MORALES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7352 STONEROCK CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8000
Mailing Address - Country:US
Mailing Address - Phone:407-351-0575
Mailing Address - Fax:407-363-6945
Practice Address - Street 1:7352 STONEROCK CIR
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8000
Practice Address - Country:US
Practice Address - Phone:407-351-0575
Practice Address - Fax:407-363-6945
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN129341223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075065400Medicaid
FLU38934Medicare ID - Type Unspecified
FL075065400Medicaid