Provider Demographics
NPI:1063495786
Name:MORRIS, DONALD JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOSEPH
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 VICTORIA CIR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-7294
Mailing Address - Country:US
Mailing Address - Phone:772-567-5676
Mailing Address - Fax:772-299-3680
Practice Address - Street 1:3850 20TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2472
Practice Address - Country:US
Practice Address - Phone:772-299-3690
Practice Address - Fax:772-299-3680
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64375207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23499OtherBCBS
FLA96110Medicare UPIN
FL23499Medicare ID - Type Unspecified