Doctor Name: | MR. LUIS RICARDO MORALES |
NPI Number: | 1255621355 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S. CCC/SLP |
License Number: | SA11215 |
Business Practice Address: | 6120 Nw 39th St Virginia Gardens, FL - 331667013 |
Business Phone Number: | 3054922740 |
Business Fax Number: | |
Mailing Address: | 6120 Nw 39th St, VIRGINIA GARDENS |
State: | FL |
Postal Code: | 331667013 |
Phone Number: | 3054922740 |
Fax Number: | |
NPI Enumeration Date: | 04/11/2011 |
NPI Last Update Date: | 02/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA11215 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |