Provider Demographics
NPI:1932290749
Name:BRIAN C. MORAES D.O., P.A.
Entity Type:Organization
Organization Name:BRIAN C. MORAES D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORAES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-883-7770
Mailing Address - Street 1:9325 GLADES RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3988
Mailing Address - Country:US
Mailing Address - Phone:561-883-7770
Mailing Address - Fax:561-883-7779
Practice Address - Street 1:9325 GLADES RD
Practice Address - Street 2:SUITE 107
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3988
Practice Address - Country:US
Practice Address - Phone:561-883-7770
Practice Address - Fax:561-883-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7601261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2130594OtherAETNA HMO
FL258524OtherAVMED
FL38219OtherNHP
FL5501766OtherAETNA NON-HMO
FL7911846OtherGHI
FL44811OtherBCBS
FLG06413OtherPHCS
FL9064736001OtherCIGNA
FL7911846OtherGHI