Provider Demographics
NPI:1588743447
Name:MORRISON, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 SW 84TH AVE
Mailing Address - Street 2:SUITE #206
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2754
Mailing Address - Country:US
Mailing Address - Phone:954-423-2300
Mailing Address - Fax:954-424-4200
Practice Address - Street 1:220 SW 84TH AVE
Practice Address - Street 2:SUITE #206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2754
Practice Address - Country:US
Practice Address - Phone:954-423-2300
Practice Address - Fax:954-424-4200
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36780208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94069OtherBC/BS
FL376360900Medicaid
FLD64671Medicare UPIN