Provider Demographics
NPI:1770345092
Name:MORALES ESCALONA, RICARDO
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:MORALES ESCALONA
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 1:901 NE 209TH TER APT 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-1228
Mailing Address - Country:US
Mailing Address - Phone:954-607-9014
Mailing Address - Fax:
Practice Address - Street 1:901 NE 209TH TER APT 206
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-1228
Practice Address - Country:US
Practice Address - Phone:954-607-9014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily