Basic Information
Provider Information
NPI: 1114462827
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARR
FirstName: MORGAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STINES
OtherFirstName: MORGAN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 25317
Address2:  
City: TAMPA
State: FL
PostalCode: 336225317
CountryCode: US
TelephoneNumber: 8132860033
FaxNumber: 8132821806
Practice Location
Address1: 100 N EDINBURGH DR
Address2:  
City: WINTER PARK
State: FL
PostalCode: 327924125
CountryCode: US
TelephoneNumber: 4076455565
FaxNumber: 4076471135
Other Information
ProviderEnumerationDate: 01/04/2017
LastUpdateDate: 10/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XME138685FLY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
10241800005FL MEDICAID
LB62001FLMEDICAREOTHER


Home