Provider Demographics
NPI:1821134974
Name:MORERA, GRETEL TERESA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:GRETEL
Middle Name:TERESA
Last Name:MORERA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:GRETEL
Other - Middle Name:TERESA
Other - Last Name:ESPINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9820 NW 51ST LN
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1916
Mailing Address - Country:US
Mailing Address - Phone:305-477-0439
Mailing Address - Fax:305-826-3618
Practice Address - Street 1:975 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3412
Practice Address - Country:US
Practice Address - Phone:305-512-5433
Practice Address - Fax:305-826-3618
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist