Provider Demographics
NPI:1598477945
Name:ROBERTO MOREJON NP
Entity Type:Organization
Organization Name:ROBERTO MOREJON NP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREJON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-370-1878
Mailing Address - Street 1:2800 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1124
Mailing Address - Country:US
Mailing Address - Phone:786-370-1878
Mailing Address - Fax:
Practice Address - Street 1:2800 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-1124
Practice Address - Country:US
Practice Address - Phone:786-370-1878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102089400Medicaid