Provider Demographics
NPI:1366857534
Name:MORRIS, CHRISTA (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4313 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4777
Mailing Address - Country:US
Mailing Address - Phone:352-378-1551
Mailing Address - Fax:
Practice Address - Street 1:4313 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4777
Practice Address - Country:US
Practice Address - Phone:352-373-4300
Practice Address - Fax:352-372-1641
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4920152W00000X
PAOEG002920152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL190MQOtherBLUE CROSS BLUE SHIELD
FLIE831YMedicare PIN
FLIN729AMedicare PIN