Provider Demographics
NPI:1205411246
Name:MORRISON, LATOYIA T
Entity Type:Individual
Prefix:
First Name:LATOYIA
Middle Name:T
Last Name:MORRISON
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 1:928 VILLAGE PL
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-5238
Mailing Address - Country:US
Mailing Address - Phone:863-557-9469
Mailing Address - Fax:
Practice Address - Street 1:928 VILLAGE PL
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33896-5238
Practice Address - Country:US
Practice Address - Phone:863-557-9469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA292183172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL85-1946856OtherHOME HEALTH