MEDICARE: BILLY MORRIS

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	363A00000X	Physician Assistant	PA9102941	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	290136	OTHER	FL	AMERIGROUP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861446197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BILLY MORRIS

Provider Business Mailing Address
First Line	:	708 DEL PRADO BLVD
Second Line	:	SUITE 9
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5616
Country	:	US
Telephone Number	:	239-574-5864
Fax Number	:	239-574-1451

Provider Business Practice Location Address
First Line	:	708 DEL PRADO BLVD
Second Line	:	SUITE 9
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5616
Country	:	US
Telephone Number	:	239-574-5864
Fax Number	:	239-574-1451

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	10/13/2008

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Directions to “ BILLY MORRIS ” Practice Location

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