Provider Demographics
NPI:1013170513
Name:MORALES, CR JEANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:CR
Middle Name:JEANNETTE
Last Name:MORALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CR
Other - Middle Name:JEANNETTE
Other - Last Name:MORALES DUCRET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1500 N DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2717
Mailing Address - Country:US
Mailing Address - Phone:561-236-1711
Mailing Address - Fax:561-736-9807
Practice Address - Street 1:1500 N DIXIE HIGHWAY
Practice Address - Street 2:SUITE 308
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2717
Practice Address - Country:US
Practice Address - Phone:561-236-1711
Practice Address - Fax:561-736-9807
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069744207ZD0900X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008184100Medicaid
FLGY846ZMedicare PIN