MEDICARE: DR. MICHAEL ANTHONY MORRISON 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	207R00000X	Internal Medicine Physician	ME51852	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07745	OTHER	FL	BLUE CROSS BLUE SHIELD
2	07745B	OTHER	FL	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124016332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ANTHONY MORRISON M.D

Provider Business Mailing Address
First Line	:	4101 NW 4TH ST
Second Line	:	STE 109
City	:	PLANTATION
State	:	FL
Zip	:	33317-2850
Country	:	US
Telephone Number	:	954-792-6900
Fax Number	:	954-792-0615

Provider Business Practice Location Address
First Line	:	4101 NW 4TH ST
Second Line	:	STE 109
City	:	PLANTATION
State	:	FL
Zip	:	33317-2850
Country	:	US
Telephone Number	:	954-792-6900
Fax Number	:	954-792-0615

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	11/08/2007

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