MEDICARE: MS. GERDA POPPEL MURPHY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW 4634	FL

General Provider Information

NPI Number	:	1023228426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GERDA POPPEL MURPHY LCSW

Provider Business Mailing Address
First Line	:	6524 SHERIDAN RD
Second Line	:
City	:	MELBOURNE VILLAGE
State	:	FL
Zip	:	32904-2212
Country	:	US
Telephone Number	:	321-951-1715
Fax Number	:	321-951-1715

Provider Business Practice Location Address
First Line	:	6524 SHERIDAN RD
Second Line	:
City	:	MELBOURNE VILLAGE
State	:	FL
Zip	:	32904-2212
Country	:	US
Telephone Number	:	321-951-1715
Fax Number	:	321-951-1715

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/09/2007

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