Healthcare Provider Details

I. General information

NPI: 1285633156
Provider Name (Legal Business Name): THOMAS C MORELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 ARCOS AVE STE 103
ESTERO FL
33928-9460
US

IV. Provider business mailing address

PO BOX 313
ESTERO FL
33929-0313
US

V. Phone/Fax

Practice location:
  • Phone: 239-949-9000
  • Fax: 239-949-9020
Mailing address:
  • Phone: 239-949-9000
  • Fax: 239-949-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME66987
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: