Organization
MORTON & BROWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFANI MEGAN REVELS LEE LMT (CEO,LMT)
(863) 443-3168
Entity
Organization
Contact information
Practice address
3625 S FLORIDA AVE, LAKELAND, FL 33803-4864
(863) 443-3168
Mailing address
2445 W HAVILAND RD, AVON PARK, FL 33825-8352
(863) 443-3168
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MA65750
FL
261QM2500X
Medical Specialty Clinic/Center
MA74492
FL
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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