MEDICARE: BARBARA MORRIS ATC

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	2255A2300X	Athletic Trainer

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AL1458	OTHER	FL	LICENSE#

General Provider Information

NPI Number	:	1194835819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA MORRIS ATC

Provider Business Mailing Address
First Line	:	909 E SAINT CLAIR ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33605-2571
Country	:	US
Telephone Number	:	813-396-9626
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 E FLETCHER AVE
Second Line	:	STE 511 MDC106
City	:	TAMPA
State	:	FL
Zip	:	33613-4708
Country	:	US
Telephone Number	:	813-396-9626
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	01/03/2008

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