MEDICARE: DR. ROBERT HARRIS DPT

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
1	225100000X	Physical Therapist	PT35250	FL

General Provider Information

NPI Number	:	1659916864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT HARRIS DPT

Provider Business Mailing Address
First Line	:	4640 SW 43RD AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33314-4723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2631 SW 27TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-2239
Country	:	US
Telephone Number	:	305-396-9002
Fax Number	:	305-390-3003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	11/12/2019

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