Provider Demographics
NPI:1104181775
Name:COURTY, MORGAN PAUL (DO)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:PAUL
Last Name:COURTY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 36TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4862
Mailing Address - Country:US
Mailing Address - Phone:772-581-5581
Mailing Address - Fax:772-581-5781
Practice Address - Street 1:801 WELLNESS WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3783
Practice Address - Country:US
Practice Address - Phone:772-581-5581
Practice Address - Fax:772-581-5781
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12815207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIM327ZMedicare PIN