Provider Demographics
NPI:1316427313
Name:MORAN, JOSUE ALBERTO (APRN)
Entity type:Individual
Prefix:
First Name:JOSUE
Middle Name:ALBERTO
Last Name:MORAN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8852 SW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2019
Mailing Address - Country:US
Mailing Address - Phone:786-897-1748
Mailing Address - Fax:786-524-3165
Practice Address - Street 1:8852 SW 25TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2019
Practice Address - Country:US
Practice Address - Phone:786-897-1748
Practice Address - Fax:786-524-3165
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-19
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9335595163WW0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WW0000XNursing Service ProvidersRegistered NurseWound Care