MEDICARE: MORGAN EYE CARE SERVICES, 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	207W00000X	Ophthalmology Physician	OS3199	FL

General Provider Information

NPI Number	:	1942446836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORGAN EYE CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	237 NW TOSCANE TRL
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-2623
Country	:	US
Telephone Number	:	772-979-0850
Fax Number	:

Provider Business Practice Location Address
First Line	:	1981 S US HIGHWAY 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-5147
Country	:	US
Telephone Number	:	772-468-6122
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOE MORGAN
Credential	:	DO
Telephone Number	:	772-979-0850

Provider Enumeration Date	:	12/23/2008
Last Update Date	:	12/23/2008

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