Provider Demographics
NPI:1245459122
Name:MORRIS, LAURA K (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:K
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 1:4121 ROSAS AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1614
Mailing Address - Country:US
Mailing Address - Phone:941-378-3675
Mailing Address - Fax:
Practice Address - Street 1:4121 ROSAS AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1614
Practice Address - Country:US
Practice Address - Phone:941-378-3675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME972202084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1301472Medicaid
BM2113594OtherDEA
F00807Medicare UPIN