=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124044649
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARRY A MORRIS PH.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1695 NW 9TH AVE
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33136-1409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-355-7124
-----------------------------------------------------
Fax | 305-355-2190
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1458 ADAMS ST
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33020-6133
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-922-5407
-----------------------------------------------------
Fax | 954-929-6608
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PY2465
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------