Provider Demographics
NPI:1417127101
Name:CAROL N MORRISON DPM PA
Entity Type:Organization
Organization Name:CAROL N MORRISON DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PODIATRIC MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:N
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:941-366-1599
Mailing Address - Street 1:2831 RINGLING BLVD
Mailing Address - Street 2:SUITE 103-A
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5334
Mailing Address - Country:US
Mailing Address - Phone:941-366-1599
Mailing Address - Fax:941-366-1599
Practice Address - Street 1:2831 RINGLING BLVD
Practice Address - Street 2:SUITE 103-A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5349
Practice Address - Country:US
Practice Address - Phone:941-366-1599
Practice Address - Fax:941-366-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 00002028213E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1324790001Medicare NSC
FLAM825AMedicare PIN
FL65112Medicare PIN
FLT95310Medicare UPIN