Provider Demographics
NPI:1538689641
Name:MORELL, ANGEL MARIO
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:MARIO
Last Name:MORELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 W FLAGLER ST APT 205
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3423
Mailing Address - Country:US
Mailing Address - Phone:786-212-1008
Mailing Address - Fax:786-334-5826
Practice Address - Street 1:9320 W FLAGLER ST APT 205
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3423
Practice Address - Country:US
Practice Address - Phone:786-212-1008
Practice Address - Fax:786-334-5826
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician