Provider Demographics
NPI:1336724806
Name:FUMERO MORALES, IRAN GERMAN (CBHCM)
Entity type:Individual
Prefix:
First Name:IRAN
Middle Name:GERMAN
Last Name:FUMERO MORALES
Suffix:
Gender:M
Credentials:CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 NW 66TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-7651
Mailing Address - Country:US
Mailing Address - Phone:786-523-6451
Mailing Address - Fax:
Practice Address - Street 1:2911 NW 66TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-7651
Practice Address - Country:US
Practice Address - Phone:786-523-6451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker