Provider Demographics
NPI:1023768728
Name:MORALES, MAX VINCENT
Entity type:Individual
Prefix:
First Name:MAX
Middle Name:VINCENT
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 1:6705 SW 57TH AVE STE 312
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3638
Mailing Address - Country:US
Mailing Address - Phone:305-670-8411
Mailing Address - Fax:305-670-8412
Practice Address - Street 1:6705 SW 57TH AVE STE 312
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3638
Practice Address - Country:US
Practice Address - Phone:305-670-8411
Practice Address - Fax:305-670-8412
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4522213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist