Basic Information
Provider Information
NPI: 1336529437
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURGASEN
FirstName: EDDIE
MiddleName: IRFAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 86 W UNDERWOOD ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328061110
CountryCode: US
TelephoneNumber: 8889123648
FaxNumber: 3218414085
Practice Location
Address1: 86 W UNDERWOOD ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 32806
CountryCode: US
TelephoneNumber: 8889123648
FaxNumber: 3218414085
Other Information
ProviderEnumerationDate: 06/03/2015
LastUpdateDate: 04/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XME133747FLY Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000XTRN21477FLN Allopathic & Osteopathic PhysiciansFamily Medicine 
208M00000XME133747FLN Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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