John Morello MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME63627 Issued in FL

Legal business name

JOHN MORELLO MD

Practice address

13111 Atlantic Blvd
Suite #4
Jacksonville, FL 32225

Phone

(904) 221-3100

Fax

(904) 221-3107

NPI assigned

Sep 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Morello, M.D.NPI 1720272644

Title

President

Phone

(904) 221-3100

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Atlantic Boulevard Dermatology Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Morello, M.D.

  • Dermatology Physician
  • Jacksonville, FL
  • NPI 1720272644
  NPD (past) Authorized official
• Morgan Metz

  • Dermatology Physician
  • Ponte Vedra Beach, FL
  • NPI 1497420293
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609975374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 OCEANSIDE CT",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322335957",
            "telephone_number": "904-247-6461",
            "fax_number": "904-247-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 ATLANTIC BLVD",
            "address_2": "SUITE #4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32225",
            "telephone_number": "904-221-3100",
            "fax_number": "904-221-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN MORELLO MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MORELLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-221-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME63627",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "FL",
            "license": "ME63627",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "FL",
            "license": "ME63627",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "FL",
            "license": "ME63627",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME63627",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "28207",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantic Boulevard Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John C. Derickson OD, PA
• John Ellison Community Recovery Center
• John Goetze Physical Therapy, Inc
• John Goetze Physical Therapy, Inc
• John Goetze Physical Therapy, Inc
• John S Boggs MD PA
• John-Paul Pham
• John-Paul Pham
• Bina Rebecca John, DNP-FNP
• Deborah John, OTR/L

• Dermatology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.