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NPI Code Detail

MEDICARE: DR. MOREY J. MENACKER D.O.

MEDICARE: DR. MOREY J. MENACKER D.O.
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
1207R00000XInternal Medicine PhysicianMB43067NJ
2207R00000XInternal Medicine PhysicianOS16624FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629017652
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOREY J. MENACKER D.O.
Provider Business Mailing Address
First Line : PO BOX 616788
Second Line :
City : ORLANDO
State : FL
Zip : 32861-6788
Country : US
Telephone Number : 407-533-6835
Fax Number : 407-770-0661
Provider Business Practice Location Address
First Line : 7649 W COLONIAL DR STE 115
Second Line :
City : ORLANDO
State : FL
Zip : 32818-7423
Country : US
Telephone Number : 407-552-2080
Fax Number : 339-630-1158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 12/14/2021

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Directions to “ DR. MOREY J. MENACKER D.O.” Practice Location

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