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NPI Code Detail

MEDICARE: NES OF SOUTHERN FLORIDA PA

MEDICARE: NES OF SOUTHERN FLORIDA PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
145754OTHERFLGROUP BCBS #

General Provider Information

NPI Number : 1225010424
Entity Type Code : Organization
Provider Name (Legal Business Name) : NES OF SOUTHERN FLORIDA PA
Provider Business Mailing Address
First Line : PO BOX 550968
Second Line :
City : TAMPA
State : FL
Zip : 33655-0968
Country : US
Telephone Number : 800-377-8721
Fax Number : 304-523-2241
Provider Business Practice Location Address
First Line : 5900 COLLEGE RD
Second Line :
City : KEY WEST
State : FL
Zip : 33040-4342
Country : US
Telephone Number : 305-294-5531
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : VINCENT MORRA
Credential :
Telephone Number : 800-377-8721
Provider Enumeration Date : 11/15/2005
Last Update Date : 12/13/2007

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Directions to “NES OF SOUTHERN FLORIDA PA ” Practice Location

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