Provider Demographics
NPI:1669439238
Name:MORELL, OMAR M
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:M
Last Name:MORELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:OMAR
Other - Middle Name:
Other - Last Name:MORELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AP
Mailing Address - Street 1:10985 SW 48TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6114
Mailing Address - Country:US
Mailing Address - Phone:305-271-0109
Mailing Address - Fax:
Practice Address - Street 1:2445 NW 97TH AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2307
Practice Address - Country:US
Practice Address - Phone:786-336-0803
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist