Provider Demographics
NPI:1699731943
Name:MORRISON, CAROL NOREEN (DPM)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:NOREEN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:N
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:2831 RINGLING BLVD
Mailing Address - Street 2:SUITE 103A
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237
Mailing Address - Country:US
Mailing Address - Phone:941-366-1599
Mailing Address - Fax:941-366-1599
Practice Address - Street 1:2831 RINGLING BLVD
Practice Address - Street 2:SUITE 103A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237
Practice Address - Country:US
Practice Address - Phone:941-366-1599
Practice Address - Fax:941-366-1599
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2028213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T95310Medicare UPIN
65112Medicare ID - Type Unspecified