Provider Demographics
NPI:1841795473
Name:MORGAN, RENEE NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:NICOLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 NW 97TH LN
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4981
Mailing Address - Country:US
Mailing Address - Phone:954-854-7322
Mailing Address - Fax:
Practice Address - Street 1:1580 NW 10TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1013
Practice Address - Country:US
Practice Address - Phone:305-243-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1502942080A0000X
IL036.153331208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine