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General NPI Number Information
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NPI Number | 1841334315
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Entity Type | Individual
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Provider Name | KERRIE MEGAN FORD PA-C, MPH
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Gender | Female
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 63 W UNDERWOOD ST
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City | ORLANDO
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State | FL
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Zip | 32806-1118
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Country | US
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Telephone | 407-872-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 1841 TUSCANY MILL WAY
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City | OCOEE
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State | FL
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Zip | 34761-9178
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Country | US
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Telephone | 407-298-5068
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9100990
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License Number State | FL
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