Provider Demographics
NPI:1609988658
Name:MORNINGSTAR MEDICAL, INC.
Entity Type:Organization
Organization Name:MORNINGSTAR MEDICAL, INC.
Other - Org Name:MORNINGSTAR SONOGRAPHY
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-860-6115
Mailing Address - Street 1:840 DELTONA BLVD STE O
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-7162
Mailing Address - Country:US
Mailing Address - Phone:386-860-6115
Mailing Address - Fax:386-860-2477
Practice Address - Street 1:840 DELTONA BLVD STE O
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-7162
Practice Address - Country:US
Practice Address - Phone:386-860-6115
Practice Address - Fax:386-860-2477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARDMS 1884335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARDMSOtherFLA. LIC. NUMBER
FLARDMSOtherFLA. LIC. NUMBER
FLARDMSOtherFLA. LIC. NUMBER