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General NPI Number Information
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NPI Number | 1285946020
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Entity Type | Individual
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Provider Name | ORLANDO MORENO MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 11/29/2020
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Provider Practice Location Address
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Address Line | 1501 BISCAYNE BLVD STE 200
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City | MIAMI
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State | FL
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Zip | 33132-1461
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Country | US
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Telephone | 786-652-2451
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Fax |
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Provider Business Mailing Address
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Address Line | 1764 SW 155TH PL
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City | MIAMI
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State | FL
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Zip | 33185-4230
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Country | US
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Telephone | 786-343-6937
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 332-PA
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 332-PA
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | NJDCATEMP-006339
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License Number State | NJ
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