Provider Demographics
NPI:1447699491
Name:MORRIS, OLYMPIA THALASSITES (PA-C)
Entity type:Individual
Prefix:MRS
First Name:OLYMPIA
Middle Name:THALASSITES
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:OLYMPIA
Other - Middle Name:
Other - Last Name:THALASSITES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0746
Mailing Address - Country:US
Mailing Address - Phone:772-288-6300
Mailing Address - Fax:
Practice Address - Street 1:506 SOUTHWEST FEDERAL HIGHWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994
Practice Address - Country:US
Practice Address - Phone:772-288-6300
Practice Address - Fax:772-288-6374
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001521A363AM0700X
FLPA9108742363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical