Provider Demographics
NPI:1679598700
Name:MOROS-RUANO, JULIO GUILLERMO (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:GUILLERMO
Last Name:MOROS-RUANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIO
Other - Middle Name:G
Other - Last Name:MOROS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:100 S. SEMORAN BLVD.
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807
Mailing Address - Country:US
Mailing Address - Phone:407-277-7622
Mailing Address - Fax:407-277-7620
Practice Address - Street 1:100 S. SEMORAN BLVD.
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807
Practice Address - Country:US
Practice Address - Phone:407-277-7620
Practice Address - Fax:407-277-7622
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL51445207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056293900Medicaid
FL51445OtherFLORIDA LICENSE
FL51445OtherFLORIDA LICENSE
FLF08269Medicare UPIN
FL12948Medicare ID - Type Unspecified