Healthcare Provider Details

I. General information

NPI: 1477291912
Provider Name (Legal Business Name): MARISSA DENISE MORGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W ATLANTIC BLVD
POMPANO BEACH FL
33060-5916
US

IV. Provider business mailing address

1608 SE 3RD AVE FL 3
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-785-4273
  • Fax: 954-784-9249
Mailing address:
  • Phone: 954-785-4273
  • Fax: 954-784-9249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME176397
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: