Provider Demographics
NPI:1376622522
Name:EDWARD MURPHY MD PA
Entity Type:Organization
Organization Name:EDWARD MURPHY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-770-0323
Mailing Address - Street 1:1285 36TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4885
Mailing Address - Country:US
Mailing Address - Phone:772-770-0323
Mailing Address - Fax:772-778-3460
Practice Address - Street 1:1285 36TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4885
Practice Address - Country:US
Practice Address - Phone:772-770-0323
Practice Address - Fax:772-778-3460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80805208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35688OtherBLUE CROSS
FLG93382Medicare UPIN
FLAE547Medicare PIN
FL35688Medicare PIN