Provider Demographics
NPI:1104885474
Name:MORGAN, JON RAYMOND (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:RAYMOND
Last Name:MORGAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4800 N FEDERAL HWY
Mailing Address - Street 2:SUITE C101
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5188
Mailing Address - Country:US
Mailing Address - Phone:561-886-0970
Mailing Address - Fax:561-886-0980
Practice Address - Street 1:11505 FAIRCHILD GARDENS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2847
Practice Address - Country:US
Practice Address - Phone:561-493-8314
Practice Address - Fax:561-493-8316
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-05-02
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Provider Licenses
StateLicense IDTaxonomies
SC6280207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCC603254810Medicare UPIN