Provider Demographics
NPI:1649040767
Name:MORINO, MORGAN (DC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:MORINO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 EXCELLENCE BLVD APT 314
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1064
Mailing Address - Country:US
Mailing Address - Phone:954-873-4634
Mailing Address - Fax:
Practice Address - Street 1:4625 E BAY DR STE 212
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6867
Practice Address - Country:US
Practice Address - Phone:727-531-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty