Provider Demographics
NPI:1821647827
Name:MORGAN MEDICAL PLLC
Entity Type:Organization
Organization Name:MORGAN MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:352-304-6566
Mailing Address - Street 1:3301 SW 34TH CIR STE 302
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6615
Mailing Address - Country:US
Mailing Address - Phone:352-304-6566
Mailing Address - Fax:352-421-9328
Practice Address - Street 1:3301 SW 34TH CIR STE 302
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6615
Practice Address - Country:US
Practice Address - Phone:352-304-6566
Practice Address - Fax:352-421-9328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104182500Medicaid