Healthcare Provider Details

I. General information

NPI: 1790616027
Provider Name (Legal Business Name): DEBORAH MORRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CRAGGY BLUFF PL
COCOA FL
32926-7421
US

IV. Provider business mailing address

3300 CRAGGY BLUFF PL
COCOA FL
32926-7421
US

V. Phone/Fax

Practice location:
  • Phone: 321-631-0373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberDO4789
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: