Provider Demographics
NPI:1861377780
Name:HERNANDEZ MORALES, LAURA MARIA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIA
Last Name:HERNANDEZ MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12360 OLIVE JONES RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3940
Mailing Address - Country:US
Mailing Address - Phone:813-244-6041
Mailing Address - Fax:
Practice Address - Street 1:12360 OLIVE JONES RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3940
Practice Address - Country:US
Practice Address - Phone:813-244-6041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician