Provider Demographics
NPI:1457105439
Name:MORALES, JOHNNY JOSEPH (LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:JOSEPH
Last Name:MORALES
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8210 ORANGE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CAPE CANAVERAL
Mailing Address - State:FL
Mailing Address - Zip Code:32920-2830
Mailing Address - Country:US
Mailing Address - Phone:863-840-5208
Mailing Address - Fax:
Practice Address - Street 1:8210 ORANGE AVE APT 1
Practice Address - Street 2:
Practice Address - City:CAPE CANAVERAL
Practice Address - State:FL
Practice Address - Zip Code:32920-2830
Practice Address - Country:US
Practice Address - Phone:863-840-5208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer