Healthcare Provider Details

I. General information

NPI: 1770313959
Provider Name (Legal Business Name): CHRISTINE MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2024
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10743 NARCOOSSEE RD STE A18
ORLANDO FL
32832-6947
US

IV. Provider business mailing address

10743 NARCOOSSEE RD STE A18
ORLANDO FL
32832-6947
US

V. Phone/Fax

Practice location:
  • Phone: 407-277-1900
  • Fax:
Mailing address:
  • Phone: 407-277-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9120478
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: