=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245325273
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MIRCEA ALBIN MORARIU JR. M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2006
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5258 LINTON BLVD SUITE #101
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484-6540
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-499-4667
-----------------------------------------------------
Fax | 561-499-5137
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5258 LINTON BLVD SUITE #101
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484-6540
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-499-4667
-----------------------------------------------------
Fax | 561-499-5137
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 0078844
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------