Provider Demographics
NPI:1376758961
Name:MORELLI, KAREN LINDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LINDA
Last Name:MORELLI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 FRANKLIN BEACH PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2470
Mailing Address - Country:US
Mailing Address - Phone:813-288-0156
Mailing Address - Fax:
Practice Address - Street 1:1060 W BUSCH BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7707
Practice Address - Country:US
Practice Address - Phone:813-931-4000
Practice Address - Fax:813-935-6532
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16578122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist