Provider Demographics
NPI:1154003663
Name:CYNTHIA MAURA MOREJON
Entity type:Organization
Organization Name:CYNTHIA MAURA MOREJON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RBT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:MAURA
Authorized Official - Last Name:MOREJON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-961-3763
Mailing Address - Street 1:11211 SW 158TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1120
Mailing Address - Country:US
Mailing Address - Phone:786-961-3763
Mailing Address - Fax:
Practice Address - Street 1:10447 SW 108TH AVE APT E278
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8115
Practice Address - Country:US
Practice Address - Phone:786-645-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health