Healthcare Provider Details

I. General information

NPI: 1790736874
Provider Name (Legal Business Name): KENNETH H MORSE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SE 17TH ST 600
OCALA FL
34471-4621
US

IV. Provider business mailing address

1500 SE 17TH ST 600
OCALA FL
34471-4621
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-8955
  • Fax: 352-732-7999
Mailing address:
  • Phone: 352-732-8955
  • Fax: 352-732-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME30760
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberME0030760
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: