Provider Demographics
NPI:1639335409
Name:MORRIS, MICHELE V
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:V
Last Name:MORRIS
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 1:1047 TAWNY EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-9611
Mailing Address - Country:US
Mailing Address - Phone:352-536-2545
Mailing Address - Fax:
Practice Address - Street 1:1047 TAWNY EAGLE DR
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-9611
Practice Address - Country:US
Practice Address - Phone:352-536-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor