Provider Demographics
NPI:1407007859
Name:MORGAN, ELIZABETH ALEXANDRA (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ALEXANDRA
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 MUNSTER ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1016
Mailing Address - Country:US
Mailing Address - Phone:904-962-3181
Mailing Address - Fax:
Practice Address - Street 1:1100 MUNSTER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1016
Practice Address - Country:US
Practice Address - Phone:904-962-3181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7774103TC0700X
FL7774103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN/AMedicaid
FLPY7774OtherMEDICAL LICENSE
FLN/AMedicaid