Organization
JOHN MORELLO MD
Active
Other names
Atlantic Boulevard Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MORELLO M.D. (PRESIDENT)
(904) 221-3100
Entity
Organization
Contact information
Practice address
13111 ATLANTIC BLVD, SUITE #4, JACKSONVILLE, FL 32225
(904) 221-3100
(904) 221-3107
Mailing address
2295 OCEANSIDE CT, ATLANTIC BEACH, FL 32233-5957
(904) 247-6461
(904) 247-2686
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME63627
FL
207ND0900X
Dermatopathology Physician
ME63627
FL
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
ME63627
FL
207NP0225X
Pediatric Dermatology Physician
ME63627
FL
207NS0135X
Procedural Dermatology Physician
ME63627
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28207
BCBS OF FL
FL
Enumeration date
09/21/2006
Last updated
03/07/2023
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