MEDICARE: MORE T CLININC LLC

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	207R00000X	Internal Medicine Physician	OS7406	FL

General Provider Information

NPI Number	:	1285031229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORE T CLININC LLC

Provider Business Mailing Address
First Line	:	155 CRANES ROOST BLVD
Second Line	:	SUITE 2060
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3468
Country	:	US
Telephone Number	:	407-949-0222
Fax Number	:	407-674-2500

Provider Business Practice Location Address
First Line	:	155 CRANES ROOST BLVD
Second Line	:	SUITE 2060
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3468
Country	:	US
Telephone Number	:	407-949-0222
Fax Number	:	407-674-2500

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BART MALONE
Credential	:
Telephone Number	:	407-949-0222

Provider Enumeration Date	:	11/19/2014
Last Update Date	:	11/19/2014

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Directions to “MORE T CLININC LLC ” Practice Location

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