MEDICARE: PETER MORRIS PTA

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	225200000X	Physical Therapy Assistant	PTA33968	FL

General Provider Information

NPI Number	:	1629324298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER MORRIS PTA

Provider Business Mailing Address
First Line	:	570 CR 486
Second Line	:
City	:	LAKE PANASOFFKEE
State	:	FL
Zip	:	33538-5832
Country	:	US
Telephone Number	:	401-788-4532
Fax Number	:

Provider Business Practice Location Address
First Line	:	2155 W MUSTANG BLVD
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3520
Country	:	US
Telephone Number	:	352-746-5707
Fax Number	:

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

Provider Enumeration Date	:	08/01/2012
Last Update Date	:	03/29/2026

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