Provider Demographics
NPI:1285633156
Name:MORELL, THOMAS C (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:MORELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 313
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33929-0313
Mailing Address - Country:US
Mailing Address - Phone:239-949-9000
Mailing Address - Fax:239-949-9020
Practice Address - Street 1:10201 ARCOS AVE STE 103
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-9460
Practice Address - Country:US
Practice Address - Phone:239-949-9000
Practice Address - Fax:239-949-9020
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME669872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25942TOtherMEDICARE PTAN