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General NPI Number Information
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NPI Number | 1700875119
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Entity Type | Individual
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Provider Name | ISMAEL S MORERA MD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 777 EAST 25TH ST STE 311
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City | HIALEAH
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State | FL
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Zip | 33013
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Country | US
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Telephone | 305-836-5627
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Fax | 305-835-4453
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Provider Business Mailing Address
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Address Line | 9737 NW 41ST ST #386
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City | MIAMI
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State | FL
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Zip | 33178
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Country | US
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Telephone | 305-836-5627
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Fax | 305-835-4453
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME0060059
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License Number State | FL
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