MEDICARE: DR. DEMETRICE DELPHINE MORRISON DCN MPH MHA RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	ND4174	FL

General Provider Information

NPI Number	:	1457413247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEMETRICE DELPHINE MORRISON DCN MPH MHA RD

Provider Business Mailing Address
First Line	:	1935 NW 183RD STREET
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056
Country	:	US
Telephone Number	:	305-318-8127
Fax Number	:	305-623-3003

Provider Business Practice Location Address
First Line	:	1935 NW 183RD STREET
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056
Country	:	US
Telephone Number	:	305-318-8127
Fax Number	:	305-623-3003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	12/06/2022

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