Provider Demographics
NPI:1821048596
Name:MOREJON, ORLANDO VICTOR (MD)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:VICTOR
Last Name:MOREJON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11760 BIRD RD
Mailing Address - Street 2:STE 722
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3582
Mailing Address - Country:US
Mailing Address - Phone:305-559-1883
Mailing Address - Fax:305-559-1887
Practice Address - Street 1:11760 BIRD RD
Practice Address - Street 2:STE 722
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-559-1883
Practice Address - Fax:305-559-1887
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63883208600000X, 2086S0102X, 2086S0127X
MO20220093202086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00376725OtherRAILROAD MEDICARE
MO201038304Medicaid
MO203380OtherBCBS
KY7100012980Medicaid
AR165406001Medicaid
735317OtherHEALTHLINK
E4618YMedicare UPIN
AR165406001Medicaid
P00376725OtherRAILROAD MEDICARE