Provider Demographics
NPI:1871754796
Name:MORERA, NEREIDA
Entity type:Individual
Prefix:
First Name:NEREIDA
Middle Name:
Last Name:MORERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10370 SW 200TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1333
Mailing Address - Country:US
Mailing Address - Phone:305-969-2718
Mailing Address - Fax:305-969-2718
Practice Address - Street 1:10370 SW 200TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1333
Practice Address - Country:US
Practice Address - Phone:305-969-2718
Practice Address - Fax:305-969-2718
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA858903747A0650X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL687444498Medicaid
FL687444496Medicaid