MEDICARE: DR. DONALD JOSEPH MORRIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME64375	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23499	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1063495786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD JOSEPH MORRIS M.D.

Provider Business Mailing Address
First Line	:	1757 VICTORIA CIR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-7294
Country	:	US
Telephone Number	:	772-567-5676
Fax Number	:	772-299-3680

Provider Business Practice Location Address
First Line	:	3850 20TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-2472
Country	:	US
Telephone Number	:	772-299-3690
Fax Number	:	772-299-3680

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	07/09/2007

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