Provider Demographics
NPI:1457828477
Name:MORALES, ELISE (CRNA)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:MORALES
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18445 SW 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6258
Mailing Address - Country:US
Mailing Address - Phone:305-710-0622
Mailing Address - Fax:
Practice Address - Street 1:7500 SW 87TH AVE STE 10
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5426
Practice Address - Country:US
Practice Address - Phone:305-595-9511
Practice Address - Fax:305-271-0383
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000767367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered