Provider Demographics
NPI:1821048596
Name:MOREJON, ORLANDO VICTOR (MD)
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:VICTOR
Last Name:MOREJON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:5153 N 9TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5719
Practice Address - Country:US
Practice Address - Phone:850-416-6159
Practice Address - Fax:850-416-7198
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME638832086S0127X, 2086S0102X, 2086S0127X
MO20220093202086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100012980Medicaid
AR165406001Medicaid
735317OtherHEALTHLINK
MO203380OtherBCBS
MO201038304Medicaid
P00376725OtherRAILROAD MEDICARE
E4618YMedicare UPIN
AR165406001Medicaid
P00376725OtherRAILROAD MEDICARE