Provider Demographics
NPI:1457413247
Name:MORRISON, DEMETRICE DELPHINE (DCN MPH MHA RD)
Entity Type:Individual
Prefix:DR
First Name:DEMETRICE
Middle Name:DELPHINE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:DCN MPH MHA RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 NW 183RD STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056
Mailing Address - Country:US
Mailing Address - Phone:305-318-8127
Mailing Address - Fax:305-623-3003
Practice Address - Street 1:1935 NW 183RD STREET
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056
Practice Address - Country:US
Practice Address - Phone:305-318-8127
Practice Address - Fax:305-623-3003
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4174133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered