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General NPI Number Information
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NPI Number | 1659801587
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Entity Type | Individual
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Provider Name | OMAR MORELL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 06/13/2017
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Provider Practice Location Address
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Address Line | 20505 S DIXIE HWY STE 1683
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City | CUTLER BAY
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State | FL
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Zip | 33189-1226
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Country | US
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Telephone | 305-232-3737
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Fax |
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Provider Business Mailing Address
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Address Line | 14459 SW 23RD TER
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City | MIAMI
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State | FL
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Zip | 33175-6322
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Country | US
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Telephone | 305-639-0169
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN22713
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License Number State | FL
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