Provider Demographics
NPI:1760064265
Name:MORRISSEY, DYLAN (MD)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:
Last Name:MORRISSEY
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 1:933 LEE RD STE 401
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-5537
Mailing Address - Country:US
Mailing Address - Phone:407-412-6799
Mailing Address - Fax:407-598-8702
Practice Address - Street 1:933 LEE RD STE 401
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-5537
Practice Address - Country:US
Practice Address - Phone:407-412-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME163845207RH0005X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist