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NPI Code Detail

MEDICARE: CARISSA MORERA

MEDICARE: CARISSA MORERA
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
1183500000XPharmacistPS61516FL

General Provider Information

NPI Number : 1457965659
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARISSA MORERA
Provider Business Mailing Address
First Line : 6790 DANIELS PKWY
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-7521
Country : US
Telephone Number : 239-433-4091
Fax Number :
Provider Business Practice Location Address
First Line : 6790 DANIELS PKWY
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-7521
Country : US
Telephone Number : 239-433-4091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2020
Last Update Date : 09/04/2020

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Directions to “ CARISSA MORERA ” Practice Location

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