Provider Demographics
NPI:1982161170
Name:MOREL, SANDY D (RN)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:D
Last Name:MOREL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16706 SW 36TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4554
Mailing Address - Country:US
Mailing Address - Phone:813-334-3322
Mailing Address - Fax:
Practice Address - Street 1:401 NW 42ND AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2882
Practice Address - Country:US
Practice Address - Phone:954-587-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011333367500000X, 367500000X
FLRN9278312163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WS0200XNursing Service ProvidersRegistered NurseSchool