Healthcare Provider Details

I. General information

NPI: 1720058571
Provider Name (Legal Business Name): THOMAS P MORRISSEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NW 13TH ST
BOCA RATON FL
33486-2305
US

IV. Provider business mailing address

701 NW 13TH ST
BOCA RATON FL
33486-2305
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5559
  • Fax: 954-659-5560
Mailing address:
  • Phone: 561-955-4986
  • Fax: 561-955-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number224909
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberME120459
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: