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NPI Code Detail

MEDICARE: MORGAN FALLON VANDALL PA

MEDICARE:   MORGAN FALLON VANDALL  PA
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
1363A00000XPhysician AssistantPA9119194FL

General Provider Information

NPI Number : 1780423350
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN FALLON VANDALL PA
Provider Business Mailing Address
First Line : PO BOX 23329
Second Line :
City : NEW YORK
State : NY
Zip : 10087-3329
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1005 E BOYER ST
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-5501
Country : US
Telephone Number : 727-934-7638
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2024
Last Update Date : 04/10/2026

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Directions to “ MORGAN FALLON VANDALL PA” Practice Location

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