Provider Demographics
NPI:1114747631
Name:MORAZAN VENTURES LLC
Entity type:Organization
Organization Name:MORAZAN VENTURES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:772-985-2937
Mailing Address - Street 1:1168 SW HUTCHINS ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2534
Mailing Address - Country:US
Mailing Address - Phone:772-985-2937
Mailing Address - Fax:
Practice Address - Street 1:1168 SW HUTCHINS ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2534
Practice Address - Country:US
Practice Address - Phone:772-985-2937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty