Healthcare Provider Details

I. General information

NPI: 1760677702
Provider Name (Legal Business Name): THOMAS D HARRIS MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 TURKEY LAKE RD STE. A
ORLANDO FL
32819-4216
US

IV. Provider business mailing address

5900 TURKEY LAKE RD SUITE A
ORLANDO FL
32819-4216
US

V. Phone/Fax

Practice location:
  • Phone: 407-351-9696
  • Fax: 407-351-8848
Mailing address:
  • Phone: 407-351-9696
  • Fax: 407-351-8848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0059581
License Number StateFL

VIII. Authorized Official

Name: THOMAS D HARRIS
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 407-351-9696