Provider Demographics
NPI:1467913616
Name:MORA MASSAD, KARINA ESTELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:KARINA
Middle Name:ESTELLE
Last Name:MORA MASSAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 E 19TH AVE # 9C03
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2560
Mailing Address - Country:US
Mailing Address - Phone:303-724-6043
Mailing Address - Fax:
Practice Address - Street 1:12700 E 19TH AVE # 9C03
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2560
Practice Address - Country:US
Practice Address - Phone:303-724-6043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0068547390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program