MEDICARE: MRS. CARI A MURRY P.A.

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	363AM0700X	Medical Physician Assistant	PA9103862	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA9103862	OTHER	FL	LICENSCE

General Provider Information

NPI Number	:	1730150087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARI A MURRY P.A.

Provider Business Mailing Address
First Line	:	3618 LANTANA ROAD
Second Line	:	SUITE 201
City	:	LAKE WORTH
State	:	FL
Zip	:	33462
Country	:	US
Telephone Number	:	561-296-2220
Fax Number	:	561-296-2221

Provider Business Practice Location Address
First Line	:	3618 LANTANA ROAD
Second Line	:	SUITE 201
City	:	LAKE WORTH
State	:	FL
Zip	:	33462
Country	:	US
Telephone Number	:	561-296-2220
Fax Number	:	561-296-2221

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	07/09/2012

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