Provider Demographics
NPI:1881650513
Name:MORRIS, DONALD BRUCE (MD, PA)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:BRUCE
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 7TH AVE N
Mailing Address - Street 2:SUITE #101
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1348
Mailing Address - Country:US
Mailing Address - Phone:727-822-3977
Mailing Address - Fax:727-822-0377
Practice Address - Street 1:1111 7TH AVE N
Practice Address - Street 2:SUITE #101
Practice Address - City:ST PETE
Practice Address - State:FL
Practice Address - Zip Code:33705
Practice Address - Country:US
Practice Address - Phone:727-822-3977
Practice Address - Fax:727-822-0377
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME59680208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370352500Medicaid
12091Medicare ID - Type Unspecified
E78184Medicare UPIN