Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | ARNP9392136 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN9392136 | FL |
NPI | 1235612771 |
---|---|
Provider Name | Luis Enrique Morera |
First Address | Miami, FL 33175-3574 |
Second Address | Aventura, FL 33180-1250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2018 |
Last Update Date | 18/10/2021 |