Provider Demographics
NPI:1750048120
Name:COLAGIOVANNI, MORGAN ROSE (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ROSE
Last Name:COLAGIOVANNI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17800 PRONGHORN ST
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:FL
Mailing Address - Zip Code:33920-3311
Mailing Address - Country:US
Mailing Address - Phone:305-607-2165
Mailing Address - Fax:
Practice Address - Street 1:17800 PRONGHORN ST
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:FL
Practice Address - Zip Code:33920-3311
Practice Address - Country:US
Practice Address - Phone:305-607-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-20
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant