MEDICARE: THOMAS EDWARD MORRILL ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9259258	FL
2	363LA2200X	Adult Health Nurse Practitioner	ARNP9259258	FL

General Provider Information

NPI Number	:	1821496118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS EDWARD MORRILL ARNP

Provider Business Mailing Address
First Line	:	11217 LONGBROOKE DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-7079
Country	:	US
Telephone Number	:	813-270-7712
Fax Number	:

Provider Business Practice Location Address
First Line	:	1123 MARBELLA PLAZA DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619
Country	:	US
Telephone Number	:	813-443-5128
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2014
Last Update Date	:	04/24/2019

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