Healthcare Provider Details

I. General information

NPI: 1801108741
Provider Name (Legal Business Name): ORLANDO OMAR HARRIS NP-F
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 ILLINOIS ST FL 9
SAN FRANCISCO CA
94143-2510
US

IV. Provider business mailing address

500 JOSEPH C WILSON BLVD
ROCHESTER NY
14627-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-9463
  • Fax: 415-476-6042
Mailing address:
  • Phone: 917-945-3883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33-336283
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: