Provider Demographics
NPI:1922106061
Name:MORALES, OMAR
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 W FLAGLER ST STE 319
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2020
Mailing Address - Country:US
Mailing Address - Phone:305-646-9196
Mailing Address - Fax:305-646-9195
Practice Address - Street 1:1701 W FLAGLER ST STE 319
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2020
Practice Address - Country:US
Practice Address - Phone:305-646-9196
Practice Address - Fax:305-646-9195
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies