Provider Demographics
NPI:1881601631
Name:MORRISON, CARYN L (OD)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:L
Last Name:MORRISON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-5382
Mailing Address - Country:US
Mailing Address - Phone:772-461-5660
Mailing Address - Fax:772-468-2134
Practice Address - Street 1:1302 SW ST LUCIE WEST BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34951
Practice Address - Country:US
Practice Address - Phone:772-340-2929
Practice Address - Fax:772-468-2134
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1887152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19947WMedicare ID - Type Unspecified
U06391Medicare UPIN