Provider Demographics
NPI:1265734396
Name:MORRISSETTE, MARIANNE REED (PT)
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:REED
Last Name:MORRISSETTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 WILLOW BEND WAY
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-6807
Mailing Address - Country:US
Mailing Address - Phone:941-302-6098
Mailing Address - Fax:
Practice Address - Street 1:218 WILLOW BEND WAY
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-6807
Practice Address - Country:US
Practice Address - Phone:941-302-6098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT3853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1265734396Medicare PIN