Healthcare Provider Details

I. General information

NPI: 1750507976
Provider Name (Legal Business Name): CHRISTINE TUZZO HARRIS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S MAIN AVE
MINNEOLA FL
34715-9578
US

IV. Provider business mailing address

600 S MAIN AVE
MINNEOLA FL
34715-9578
US

V. Phone/Fax

Practice location:
  • Phone: 407-399-8855
  • Fax: 321-248-0120
Mailing address:
  • Phone: 407-399-8855
  • Fax: 321-248-0120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW5509
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: