Healthcare Provider Details

I. General information

NPI: 1184534331
Provider Name (Legal Business Name): JOHN-GREGORY MORIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 NE 125TH ST STE 320
NORTH MIAMI FL
33161-5010
US

IV. Provider business mailing address

2401 OVERBROOK ST APT 102
MIAMI FL
33133-3196
US

V. Phone/Fax

Practice location:
  • Phone: 786-842-0444
  • Fax: 561-634-2776
Mailing address:
  • Phone: 305-491-9996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMT4722
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: