Healthcare Provider Details

I. General information

NPI: 1295140085
Provider Name (Legal Business Name): JESSE ALAN MORSE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 BISCAYNE BLVD STE 406
MIAMI FL
33137-3737
US

IV. Provider business mailing address

3915 BISCAYNE BLVD STE 406
MIAMI FL
33137-3737
US

V. Phone/Fax

Practice location:
  • Phone: 305-367-1176
  • Fax:
Mailing address:
  • Phone: 305-367-1176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME136467
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: