Provider Demographics
NPI:1093184053
Name:TRESCIANA MORGAN MD, P.A.
Entity Type:Organization
Organization Name:TRESCIANA MORGAN MD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRESCIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-609-2365
Mailing Address - Street 1:7000 W CAMINO REAL
Mailing Address - Street 2:SUITE #210
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5532
Mailing Address - Country:US
Mailing Address - Phone:561-609-2365
Mailing Address - Fax:561-609-2437
Practice Address - Street 1:7000 W CAMINO REAL
Practice Address - Street 2:SUITE #210
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5532
Practice Address - Country:US
Practice Address - Phone:561-609-2365
Practice Address - Fax:561-609-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12061590OtherCAQH
FL12061590OtherCAQH