Provider Demographics
NPI:1952756231
Name:MORALES, KAMILL (MS, SLP)
Entity Type:Individual
Prefix:
First Name:KAMILL
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 EMMETT ST STE 102
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-3605
Mailing Address - Country:US
Mailing Address - Phone:407-913-1010
Mailing Address - Fax:407-992-8697
Practice Address - Street 1:1000 EMMETT ST STE 102
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-3605
Practice Address - Country:US
Practice Address - Phone:407-913-1010
Practice Address - Fax:407-992-8697
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA15218235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102995500Medicaid