Provider Demographics
NPI:1811298839
Name:ASTRID MORALES LLC
Entity type:Organization
Organization Name:ASTRID MORALES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:941-525-6988
Mailing Address - Street 1:2160 HERON LAKE DR UNIT 303
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-6734
Mailing Address - Country:US
Mailing Address - Phone:941-268-0775
Mailing Address - Fax:941-875-9748
Practice Address - Street 1:2160 HERON LAKE DR UNIT 303
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33983-6734
Practice Address - Country:US
Practice Address - Phone:941-268-0775
Practice Address - Fax:941-875-9748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7780225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty