Provider Demographics
NPI:1831948033
Name:MORALES CARRILLO, ARIAN (APRN)
Entity type:Individual
Prefix:MR
First Name:ARIAN
Middle Name:
Last Name:MORALES CARRILLO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7353 LOCH NESS DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6009
Mailing Address - Country:US
Mailing Address - Phone:786-474-1134
Mailing Address - Fax:
Practice Address - Street 1:7353 LOCH NESS DR
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6009
Practice Address - Country:US
Practice Address - Phone:786-474-1134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-18
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty