Healthcare Provider Details

I. General information

NPI: 1669667622
Provider Name (Legal Business Name): LINDA S MORSE DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 49TH ST N STE S 201
ST PETERSBURG FL
33709-2146
US

IV. Provider business mailing address

5800 49TH ST N STE S 201
ST PETERSBURG FL
33709-2146
US

V. Phone/Fax

Practice location:
  • Phone: 727-525-4699
  • Fax: 727-525-4799
Mailing address:
  • Phone: 727-525-4699
  • Fax: 727-525-4799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOS6786
License Number StateFL

VIII. Authorized Official

Name: MRS. DANA M WAINWRIGHT
Title or Position: OFFICE MANAGER
Credential:
Phone: 727-525-4699