MEDICARE: MR. GREGORY MARSHALL MORRIS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	ARNP9200404	FL

General Provider Information

NPI Number	:	1184667065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY MARSHALL MORRIS CRNA

Provider Business Mailing Address
First Line	:	548 BOCA CIEGA POINT BLVD S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33708-2720
Country	:	US
Telephone Number	:	727-418-9794
Fax Number	:

Provider Business Practice Location Address
First Line	:	548 BOCA CIEGA POINT BLVD S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33708-2720
Country	:	US
Telephone Number	:	727-418-9794
Fax Number	:

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	08/15/2013

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