Healthcare Provider Details

I. General information

NPI: 1982960621
Provider Name (Legal Business Name): AMIE LUANN HARVEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CHILD ST
JACKSONVILLE FL
32214-5005
US

IV. Provider business mailing address

7021 DOREEN ST
TAMPA FL
33617-8436
US

V. Phone/Fax

Practice location:
  • Phone: 904-542-7276
  • Fax: 904-542-7913
Mailing address:
  • Phone: 360-362-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101254464
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: