Provider Demographics
NPI:1154149243
Name:MORALES SOTO, ALEJANDRO MIGUEL (SA-C)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:MIGUEL
Last Name:MORALES SOTO
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 1:12 PECAN DRIVE CRSE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-6139
Mailing Address - Country:US
Mailing Address - Phone:352-713-3274
Mailing Address - Fax:
Practice Address - Street 1:12 PECAN DRIVE CRSE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-6139
Practice Address - Country:US
Practice Address - Phone:352-713-3274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-441246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant