Provider Demographics
NPI:1396130829
Name:MORRA, AMBER ROSE (DPM)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:ROSE
Last Name:MORRA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 INDIAN RIVER BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4800
Mailing Address - Country:US
Mailing Address - Phone:772-569-2330
Mailing Address - Fax:772-569-2630
Practice Address - Street 1:3955 INDIAN RIVER BLVD
Practice Address - Street 2:STE 100
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4800
Practice Address - Country:US
Practice Address - Phone:772-569-2330
Practice Address - Fax:772-569-2630
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLPO4080213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program