Provider Demographics
NPI:1215982905
Name:MORALES, ALICE (MD)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3111 TIFFANY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BELLEAIR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33786
Mailing Address - Country:US
Mailing Address - Phone:727-480-7929
Mailing Address - Fax:727-288-1111
Practice Address - Street 1:9912 LITTLE ROAD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654
Practice Address - Country:US
Practice Address - Phone:727-869-4100
Practice Address - Fax:727-869-4197
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME613542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G87003Medicare UPIN
FL31836ZMedicare ID - Type Unspecified