Healthcare Provider Details

I. General information

NPI: 1831178102
Provider Name (Legal Business Name): JEFFREY JOHN HARROW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 03/07/2023
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14948 LAKE FOREST DR
LUTZ FL
33559-3298
US

IV. Provider business mailing address

14948 LAKE FOREST DR
LUTZ FL
33559-3298
US

V. Phone/Fax

Practice location:
  • Phone: 813-898-9829
  • Fax:
Mailing address:
  • Phone: 813-898-9829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number165540-8905
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9400828
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2017-0722
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number9400828
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME136877
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: