Provider Demographics
NPI:1558598193
Name:MORGAN, MELISSA ALLYN (DO)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ALLYN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 GULF TO BAY BLVD APT 9303
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-4057
Mailing Address - Country:US
Mailing Address - Phone:305-905-2539
Mailing Address - Fax:727-437-7586
Practice Address - Street 1:2855 GULF TO BAY BLVD APT 9303
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-4057
Practice Address - Country:US
Practice Address - Phone:305-905-2539
Practice Address - Fax:727-437-7586
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259569-1207Q00000X
390200000X
FLOS129122083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program