Provider Demographics
NPI:1609208545
Name:DEMBINSKI, MORGAN MATHIAS (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:MATHIAS
Last Name:DEMBINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MORGAN
Other - Middle Name:ANNE
Other - Last Name:MATHIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0417
Mailing Address - Country:US
Mailing Address - Phone:772-223-2832
Mailing Address - Fax:772-223-5646
Practice Address - Street 1:509 SE RIVERSIDE DR STE 303
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2579
Practice Address - Country:US
Practice Address - Phone:772-283-9111
Practice Address - Fax:772-283-2955
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9107342363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0K4WOtherFLORIDA BLUE
FL009591600Medicaid
FLHO084ZMedicare PIN