MEDICARE: MICHELE G. MORROW D.O., P.A.

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
1	207Q00000X	Family Medicine Physician	0S06289	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	80703	OTHER	FL	MEDICARE PROVIDER NUMBER

General Provider Information

NPI Number	:	1518114727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELE G. MORROW D.O., P.A.

Provider Business Mailing Address
First Line	:	PO BOX 800407
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33280-0407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 NW 1ST ST STE 110
Second Line	:	3270 N. W. 36TH STREET
City	:	MIAMI
State	:	FL
Zip	:	33128-1902
Country	:	US
Telephone Number	:	786-466-7200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT, VICE PRESIDENT, TREASURE
Name	:	MICHELE GARETT MORROW
Credential	:	D.O.
Telephone Number	:	786-282-2212

Provider Enumeration Date	:	08/20/2008
Last Update Date	:	08/20/2008

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