Provider Demographics
NPI:1134761802
Name:MORRIS, CYNTHIA VANCE (ARNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:VANCE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:VANCE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:2843 PALM HARBOR BLVD FL 34683
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1926
Mailing Address - Country:US
Mailing Address - Phone:502-938-4870
Mailing Address - Fax:727-787-2384
Practice Address - Street 1:2843 PALM HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-1926
Practice Address - Country:US
Practice Address - Phone:003-872-7772
Practice Address - Fax:727-787-2384
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL110043112084P0802X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMM5532925OtherDEA