Healthcare Provider Details

I. General information

NPI: 1043181738
Provider Name (Legal Business Name): TARRYN HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 RINEHART RD
LAKE MARY FL
32746-2551
US

IV. Provider business mailing address

790 BRIARWOOD CT
ORANGE CITY FL
32763-4318
US

V. Phone/Fax

Practice location:
  • Phone: 407-767-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberRN9567842
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: