Provider Demographics
NPI:1336598580
Name:MORIN, ANDY
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:MORIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 SW 23RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3956
Mailing Address - Country:US
Mailing Address - Phone:305-790-0086
Mailing Address - Fax:
Practice Address - Street 1:8180 NW 36TH ST STE 209
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6653
Practice Address - Country:US
Practice Address - Phone:786-587-0424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other