Provider Demographics
NPI:1760461057
Name:REYES-MOROZ, CELIA (MD)
Entity type:Individual
Prefix:
First Name:CELIA
Middle Name:
Last Name:REYES-MOROZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CELIA
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1960 NE 47TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-7708
Mailing Address - Country:US
Mailing Address - Phone:954-493-5005
Mailing Address - Fax:954-938-0957
Practice Address - Street 1:1960 NE 47TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-7708
Practice Address - Country:US
Practice Address - Phone:954-493-5005
Practice Address - Fax:954-938-0957
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME33375207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050063737OtherRAILROAD MEDICARE
FL204929OtherAVMED
FL035843600Medicaid
FL93959OtherBCBS OF FLORIDA
FL035843600Medicaid
FL93959ZMedicare ID - Type Unspecified