Provider Demographics
NPI:1992082598
Name:MORGAN, MICHAEL JAY (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAY
Last Name:MORGAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6506 CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-4778
Mailing Address - Country:US
Mailing Address - Phone:850-810-3002
Mailing Address - Fax:850-983-9304
Practice Address - Street 1:6671 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4781
Practice Address - Country:US
Practice Address - Phone:850-564-7722
Practice Address - Fax:850-665-3751
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist