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NPI Code Detail

MEDICARE: VERNIECEA J HARRIS MD

MEDICARE: VERNIECEA J HARRIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME161530FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104443126
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERNIECEA J HARRIS MD
Provider Business Mailing Address
First Line : 2627 RIVERSIDE AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32204-4717
Country : US
Telephone Number : 904-308-7372
Fax Number :
Provider Business Practice Location Address
First Line : 4844 DEER LAKE DR W STE 1
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-4506
Country : US
Telephone Number : 904-738-8690
Fax Number : 904-390-7426
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2020
Last Update Date : 12/31/2024

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Directions to “ VERNIECEA J HARRIS MD” Practice Location

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