Healthcare Provider Details

I. General information

NPI: 1164931036
Provider Name (Legal Business Name): GRETER MOREJON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9338 SW 144TH PL
MIAMI FL
33186-1086
US

IV. Provider business mailing address

9338 SW 144TH PL
MIAMI FL
33186-1086
US

V. Phone/Fax

Practice location:
  • Phone: 305-984-3736
  • Fax:
Mailing address:
  • Phone: 305-984-3736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: