Provider Demographics
NPI:1851408587
Name:MORALES, CLARE (RNFA)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13481 LA MIRADA CIR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3955
Mailing Address - Country:US
Mailing Address - Phone:561-964-2211
Mailing Address - Fax:561-649-2915
Practice Address - Street 1:4665 S CONGRESS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4754
Practice Address - Country:US
Practice Address - Phone:561-964-2211
Practice Address - Fax:561-649-2915
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN1846872363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL310914300Medicaid