Provider Demographics
NPI:1437997475
Name:VICTORIA MORALES, WILLIAM (SA-C)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:VICTORIA MORALES
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11851 SW 42ND PL UNIT 313
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-8071
Mailing Address - Country:US
Mailing Address - Phone:754-324-0718
Mailing Address - Fax:
Practice Address - Street 1:11851 SW 42ND PL UNIT 313
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-8071
Practice Address - Country:US
Practice Address - Phone:754-324-0718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-195246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant