Healthcare Provider Details

I. General information

NPI: 1457342560
Provider Name (Legal Business Name): HARRY R PAPPAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 BOSTON AVE
ALTAMONTE SPRINGS FL
32701-4706
US

IV. Provider business mailing address

160 BOSTON AVE
ALTAMONTE SPRINGS FL
32701-4798
US

V. Phone/Fax

Practice location:
  • Phone: 407-834-7776
  • Fax: 407-834-0973
Mailing address:
  • Phone: 407-775-7654
  • Fax: 407-834-6082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME46535
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberME66619
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: