Provider Demographics
NPI:1497399273
Name:MOREJON, YOHANNA
Entity Type:Individual
Prefix:
First Name:YOHANNA
Middle Name:
Last Name:MOREJON
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 1:4301 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3002
Mailing Address - Country:US
Mailing Address - Phone:954-331-3613
Mailing Address - Fax:954-331-3617
Practice Address - Street 1:4301 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3002
Practice Address - Country:US
Practice Address - Phone:954-331-3613
Practice Address - Fax:954-331-3617
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist