Provider Demographics
NPI:1992452643
Name:MORALES, DARLA RUBIO (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:RUBIO
Last Name:MORALES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:DARLA
Other - Middle Name:RUBIO
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20000 N 57TH AVE RM H210
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6877
Mailing Address - Country:US
Mailing Address - Phone:760-996-6527
Mailing Address - Fax:
Practice Address - Street 1:13755 N LITCHFIELD RD STE 105
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-4288
Practice Address - Country:US
Practice Address - Phone:623-251-3844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8967363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant