MEDICARE: MORGAN ALEXIS BECK PTA

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	225200000X	Physical Therapy Assistant	PTA32453	FL

General Provider Information

NPI Number	:	1194433607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN ALEXIS BECK PTA

Provider Business Mailing Address
First Line	:	867 COPPERFIELD TER
Second Line	:
City	:	CASSELBERRY
State	:	FL
Zip	:	32707-5828
Country	:	US
Telephone Number	:	407-276-1417
Fax Number	:

Provider Business Practice Location Address
First Line	:	4257 DAUBERT ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4369
Country	:	US
Telephone Number	:	321-218-0435
Fax Number	:

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

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	11/14/2022

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