Provider Demographics
NPI:1821085051
Name:MORRIS, MERRI BETH (MD)
Entity Type:Individual
Prefix:
First Name:MERRI
Middle Name:BETH
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 S TAMPA AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-3646
Mailing Address - Country:US
Mailing Address - Phone:407-246-1788
Mailing Address - Fax:407-246-8466
Practice Address - Street 1:726 S TAMPA AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-3646
Practice Address - Country:US
Practice Address - Phone:407-246-1788
Practice Address - Fax:407-246-8466
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29780207V00000X
AZ16271207V00000X
TN021413207V00000X
SC23158207VG0400X
FLME96883207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3062135Medicaid
FL004517200Medicaid
FL004517200Medicaid