Provider Demographics
NPI:1457582520
Name:MORALES MORALES, WYNED W (MD)
Entity type:Individual
Prefix:DR
First Name:WYNED
Middle Name:W
Last Name:MORALES MORALES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:800-480-5243
Mailing Address - Fax:800-928-7449
Practice Address - Street 1:101 DIVINE DR STE 1
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33897-9571
Practice Address - Country:US
Practice Address - Phone:863-256-3225
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2024-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR17696208D00000X
FLACN930208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice