Healthcare Provider Details

I. General information

NPI: 1407849581
Provider Name (Legal Business Name): MORGAN MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 GOODLETTE RD N STE 101
NAPLES FL
34102-5616
US

IV. Provider business mailing address

1455 BROAD ST 4TH FLOOR
BLOOMFIELD NJ
07003-3003
US

V. Phone/Fax

Practice location:
  • Phone: 888-440-6494
  • Fax: 239-262-4216
Mailing address:
  • Phone: 973-707-1100
  • Fax: 973-707-1127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberHCC 3684
License Number StateFL

VIII. Authorized Official

Name: LAURA POZUELOS
Title or Position: MANAGER OF CORPORATE BILLING
Credential:
Phone: 973-873-9895