Provider Demographics
NPI:1053059451
Name:MORA MEDICAL (FL), PLLC
Entity Type:Organization
Organization Name:MORA MEDICAL (FL), PLLC
Other - Org Name:MORA MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARBAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-620-0345
Mailing Address - Street 1:6303 BLUE LAGOON DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-6002
Mailing Address - Country:US
Mailing Address - Phone:949-791-9745
Mailing Address - Fax:877-349-3970
Practice Address - Street 1:REGUS, MIAMI AIRPORT, WATERFORD (OFFICE SUITES)
Practice Address - Street 2:6303 BLUE LAGOON DRIVE WATERFORD, #400
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126
Practice Address - Country:US
Practice Address - Phone:949-688-0246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty