Provider Demographics
NPI:1770805079
Name:MORELL, ADRIAN (LMT, CNMT)
Entity type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:
Last Name:MORELL
Suffix:
Gender:M
Credentials:LMT, CNMT
Other - Prefix:MR
Other - First Name:ADRIAN
Other - Middle Name:
Other - Last Name:MORELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPHT, RPHT
Mailing Address - Street 1:PO BOX 51146
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-0330
Mailing Address - Country:US
Mailing Address - Phone:941-524-9791
Mailing Address - Fax:
Practice Address - Street 1:9070 58TH DR E STE 102
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-6110
Practice Address - Country:US
Practice Address - Phone:941-524-9791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-28
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT22660183700000X
FLMA53254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No183700000XPharmacy Service ProvidersPharmacy Technician