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General NPI Number Information
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NPI Number | 1427205970
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Entity Type | Organization
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Legal Business Name | MORTON PLANT MEASE PRIMARY CARE INC
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 120 PINE AVE N
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City | OLDSMAR
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State | FL
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Zip | 34677-4679
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Country | US
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Telephone | 813-814-9504
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Fax | 813-814-0409
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Provider Business Mailing Address
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Address Line | 2995 DREW STREET EAST BLDG 2ND FLOOR
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City | CLEARWATER
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State | FL
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Zip | 33759
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Country | US
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Telephone | 727-281-9390
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Fax | 813-635-2613
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Authorized Official
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Title or Position | VP
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Name | LYNDA A GORKEN
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Credential |
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Telephone | 727-281-9390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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