Basic Information
| Provider Information | |||||||||
| NPI: | 1598970287 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORALES | ||||||||
| FirstName: | CHERI | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP, RCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4200 N ARMENIA AVE STE 1 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336076451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138774811 | ||||||||
| FaxNumber: | 8138728978 | ||||||||
| Practice Location | |||||||||
| Address1: | 9170 OAKHURST RD | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SEMINOLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337762112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275173376 | ||||||||
| FaxNumber: | 7275173370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2007 | ||||||||
| LastUpdateDate: | 07/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP2224262 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | E8385Y | 01 | FL | MEDICARE PTAN | OTHER |