Provider Demographics
NPI:1881104602
Name:MORELL, ROLANDO ANTONIO
Entity type:Individual
Prefix:
First Name:ROLANDO
Middle Name:ANTONIO
Last Name:MORELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10067 PINES BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6136
Mailing Address - Country:US
Mailing Address - Phone:954-430-7777
Mailing Address - Fax:
Practice Address - Street 1:10067 PINES BLVD STE B
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6136
Practice Address - Country:US
Practice Address - Phone:954-430-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW352176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife