Healthcare Provider Details

I. General information

NPI: 1578546776
Provider Name (Legal Business Name): MORTON PLANT HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27001 US HIGHWAY 19 N SUITE 8280
CLEARWATER FL
33761-3402
US

IV. Provider business mailing address

2995 DREW STREET EAST BLDG 2ND FLOOR
CLEARWATER FL
33759
US

V. Phone/Fax

Practice location:
  • Phone: 727-796-2056
  • Fax:
Mailing address:
  • Phone: 727-281-9390
  • Fax: 813-635-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: TAMBLYN CUBERO
Title or Position: MANAGER
Credential:
Phone: 727-281-9390