Provider Demographics
NPI:1629892765
Name:VILORIA MORENO, MERYHENNIFER KATTERINE
Entity type:Individual
Prefix:
First Name:MERYHENNIFER
Middle Name:KATTERINE
Last Name:VILORIA MORENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16934 SW 92ND STREET CIR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4749
Mailing Address - Country:US
Mailing Address - Phone:786-622-4004
Mailing Address - Fax:
Practice Address - Street 1:16934 SW 92ND STREET CIR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-4749
Practice Address - Country:US
Practice Address - Phone:786-622-4004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM.0105633104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker