Provider Demographics
NPI:1427287200
Name:MORALES, ASTRID (OT)
Entity type:Individual
Prefix:
First Name:ASTRID
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 HERON LAKE DR UNIT 303J
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-6734
Mailing Address - Country:US
Mailing Address - Phone:941-525-6988
Mailing Address - Fax:
Practice Address - Street 1:2160 HERON LAKE DR UNIT 303J
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33983-6734
Practice Address - Country:US
Practice Address - Phone:941-525-6988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7780225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist