MEDICARE: MULVA H PEARSON MD

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	207Q00000X	Family Medicine Physician	ME65429	FL

General Provider Information

NPI Number	:	1306820584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MULVA H PEARSON MD

Provider Business Mailing Address
First Line	:	PO BOX 474
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-0474
Country	:	US
Telephone Number	:	407-705-3424
Fax Number	:

Provider Business Practice Location Address
First Line	:	2295 S HIAWASSEE RD STE 210
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-8748
Country	:	US
Telephone Number	:	407-705-3424
Fax Number	:

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	12/16/2022

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