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Individual

MR. MATTHEW JOHN MORRISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1690 DUNLAWTON AVE STE 210, PORT ORANGE, FL 32127-8980
(386) 763-4920
(386) 763-4939
Mailing address
2805 S ASCIANO CT, NEW SMYRNA BEACH, FL 32168-6322
(386) 566-0584

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 9100655
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
290535300
FL
Enumeration date
10/12/2005
Last updated
04/30/2021
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