Provider Demographics
NPI:1144720640
Name:MORRIS, JEFFREY (DO)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 SW 163RD AVE
Mailing Address - Street 2:
Mailing Address - City:SW RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33331-1448
Mailing Address - Country:US
Mailing Address - Phone:954-881-5661
Mailing Address - Fax:
Practice Address - Street 1:8620 E COUNTY ROAD 466
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-3670
Practice Address - Country:US
Practice Address - Phone:305-284-7761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS18710207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program