Provider Demographics
NPI:1194792994
Name:SOCORRO MORALES, CARMEN (RN)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:SOCORRO MORALES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 BOGGY CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-9516
Mailing Address - Country:US
Mailing Address - Phone:407-943-8690
Mailing Address - Fax:407-892-6468
Practice Address - Street 1:150 GRAPE AVE
Practice Address - Street 2:
Practice Address - City:ST CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769
Practice Address - Country:US
Practice Address - Phone:407-943-8690
Practice Address - Fax:407-892-6468
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2713112163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse