Provider Demographics
NPI:1659466365
Name:CHARLES A MORGAN MD PA
Entity Type:Organization
Organization Name:CHARLES A MORGAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-886-9807
Mailing Address - Street 1:PO BOX 2555
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32704-2555
Mailing Address - Country:US
Mailing Address - Phone:407-886-9807
Mailing Address - Fax:407-886-9806
Practice Address - Street 1:380 SEMORAN COMMERCE PL # B
Practice Address - Street 2:STE 210
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4654
Practice Address - Country:US
Practice Address - Phone:407-886-9807
Practice Address - Fax:407-886-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME24104207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064294100Medicaid
D85841Medicare UPIN
FLQ0425Medicare PIN