Provider Demographics
NPI:1255929964
Name:QUINN, MORGAN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PLANTATION ISLAND DR S STE 106A
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3109
Mailing Address - Country:US
Mailing Address - Phone:904-814-8365
Mailing Address - Fax:904-217-3224
Practice Address - Street 1:1301 PLANTATION ISLAND DR S STE 106A
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3109
Practice Address - Country:US
Practice Address - Phone:904-824-4990
Practice Address - Fax:904-217-3224
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9118480363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant