MEDICARE: MORTON PLANT HEALTH SERVICES, INC

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	246ZE0500X	EEG Specialist/Technologist
2	246X00000X	Cardiovascular Specialist/Technologist

General Provider Information

NPI Number	:	1578546776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORTON PLANT HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	2995 DREW STREET
Second Line	:	EAST BLDG 2ND FLOOR
City	:	CLEARWATER
State	:	FL
Zip	:	33759
Country	:	US
Telephone Number	:	727-281-9390
Fax Number	:	813-635-2613

Provider Business Practice Location Address
First Line	:	27001 US HIGHWAY 19 N
Second Line	:	SUITE 8280
City	:	CLEARWATER
State	:	FL
Zip	:	33761-3402
Country	:	US
Telephone Number	:	727-796-2056
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TAMBLYN CUBERO
Credential	:
Telephone Number	:	727-281-9390

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	01/16/2019

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