Healthcare Provider Details

I. General information

NPI: 1932593266
Provider Name (Legal Business Name): MORGAN CALLAHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 01/19/2021
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2621 CATTLEMEN RD STE 202
SARASOTA FL
34232-6212
US

IV. Provider business mailing address

2621 CATTLEMEN RD STE 202
SARASOTA FL
34232-6212
US

V. Phone/Fax

Practice location:
  • Phone: 941-365-5672
  • Fax:
Mailing address:
  • Phone: 941-365-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME144402
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME144402
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: