Provider Demographics
NPI:1831794734
Name:MOR, IRENA (RPH)
Entity type:Individual
Prefix:MRS
First Name:IRENA
Middle Name:
Last Name:MOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 CORPORATE CENTER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1213
Mailing Address - Country:US
Mailing Address - Phone:305-432-0619
Mailing Address - Fax:401-335-7376
Practice Address - Street 1:7205 CORPORATE CENTER DR STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-1213
Practice Address - Country:US
Practice Address - Phone:305-432-0619
Practice Address - Fax:401-335-7376
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist