MEDICARE: DR. RONNIE MORRIS MD

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	ME70980	FL

General Provider Information

NPI Number	:	1750317749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONNIE MORRIS MD

Provider Business Mailing Address
First Line	:	2500 QUANTUM LAKES DR
Second Line	:	SUITE 108
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8324
Country	:	US
Telephone Number	:	561-244-3643
Fax Number	:

Provider Business Practice Location Address
First Line	:	1424 COMMERCIAL PARK DR
Second Line	:	SUITE 3
City	:	LAKELAND
State	:	FL
Zip	:	33801-6565
Country	:	US
Telephone Number	:	863-683-5574
Fax Number	:

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/08/2007

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