Provider Demographics
NPI:1619167962
Name:MORALES-PEREZ, RAMON ANTONIO (PTA)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:ANTONIO
Last Name:MORALES-PEREZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14369 64TH WAY N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33418-7214
Mailing Address - Country:US
Mailing Address - Phone:561-541-0744
Mailing Address - Fax:
Practice Address - Street 1:14369 64TH WAY N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33418-7214
Practice Address - Country:US
Practice Address - Phone:561-541-0744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA001315225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant