Provider Demographics
NPI:1427779255
Name:MORAMARCO, MIKE JOSEPH
Entity type:Individual
Prefix:
First Name:MIKE
Middle Name:JOSEPH
Last Name:MORAMARCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:JOSEPH
Other - Last Name:MORAMARCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1801 WATERMARK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-7088
Mailing Address - Country:US
Mailing Address - Phone:614-438-3400
Mailing Address - Fax:
Practice Address - Street 1:12353 HAMPTON PARK BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-4105
Practice Address - Country:US
Practice Address - Phone:813-542-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical