Provider Demographics
NPI:1366271371
Name:MORALES DE CASTILLO, REBECCA ANGELA (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANGELA
Last Name:MORALES DE CASTILLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANGELA
Other - Last Name:MORALES PORRATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8252 PENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4449
Mailing Address - Country:US
Mailing Address - Phone:727-543-3887
Mailing Address - Fax:
Practice Address - Street 1:36037 US HIGHWAY 19 N STE 106
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1531
Practice Address - Country:US
Practice Address - Phone:727-371-4693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL51442931279246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty