Healthcare Provider Details

I. General information

NPI: 1134761802
Provider Name (Legal Business Name): CYNTHIA VANCE MORRIS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA VANCE MORRIS PMHNP-BC

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 03/07/2023
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2843 PALM HARBOR BLVD
PALM HARBOR FL
34683-1926
US

IV. Provider business mailing address

2843 PALM HARBOR BLVD FL 34683
PALM HARBOR FL
34683-1926
US

V. Phone/Fax

Practice location:
  • Phone: 3-872-7772
  • Fax: 727-787-2384
Mailing address:
  • Phone: 502-938-4870
  • Fax: 727-787-2384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number11004311
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number11004311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: