Healthcare Provider Details

I. General information

NPI: 1275598898
Provider Name (Legal Business Name): CHARLES ROSS MORRISON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: C. ROSS MORRISON M.D.

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2881 HYDE PARK ST
SARASOTA FL
34239-3228
US

IV. Provider business mailing address

419 MADISON DR
SARASOTA FL
34236-1411
US

V. Phone/Fax

Practice location:
  • Phone: 941-366-5440
  • Fax: 941-366-5793
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME87767
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: