Provider Demographics
NPI:1205937471
Name:MORRIS, JEFFERY ALLEN (PT)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:ALLEN
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 36TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4811
Mailing Address - Country:US
Mailing Address - Phone:772-567-8040
Mailing Address - Fax:772-567-8420
Practice Address - Street 1:1345 36TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4811
Practice Address - Country:US
Practice Address - Phone:772-567-8040
Practice Address - Fax:772-567-8420
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 28347225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5025601Medicare PIN