Provider Demographics
NPI:1942217526
Name:MORALES, OSMIN (MD)
Entity Type:Individual
Prefix:
First Name:OSMIN
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 SW 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3420
Mailing Address - Country:US
Mailing Address - Phone:786-558-4654
Mailing Address - Fax:786-238-7950
Practice Address - Street 1:7001 SW 61ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3420
Practice Address - Country:US
Practice Address - Phone:786-558-4654
Practice Address - Fax:786-238-7950
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00745492081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255981100Medicaid
FL255981100Medicaid
FL44991AMedicare PIN