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General NPI Number Information
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NPI Number | 1386294007
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Entity Type | Individual
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Provider Name | SAMANTHA M MORELL PTA
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Gender | Female
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Dates
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Enumeration Date | 09/14/2019
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Last Update Date | 09/14/2019
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Provider Practice Location Address
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Address Line | 311 NE 8TH ST STE 104
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City | HOMESTEAD
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State | FL
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Zip | 33030-4734
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Country | US
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Telephone | 305-248-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 10745 SW 3RD ST APT 7
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City | MIAMI
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State | FL
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Zip | 33174-1475
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Country | US
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Telephone | 305-951-8673
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA29639
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License Number State | FL
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