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General NPI Number Information
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NPI Number | 1740371921
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Entity Type | Individual
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Provider Name | DARELD RAY MORRIS II D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 45 BRYAN AVE
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City | LABELLE
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State | FL
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Zip | 33935-4647
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Country | US
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Telephone | 863-675-3427
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Fax | 863-675-3809
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Provider Business Mailing Address
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Address Line | 6800 PORTO FINO CIRCLE
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City | FORT MYERS
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State | FL
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Zip | 33912-7133
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Country | US
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Telephone | 239-418-0775
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Fax | 239-418-0630
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS6547
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License Number State | FL
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