Healthcare Provider Details

I. General information

NPI: 1336249838
Provider Name (Legal Business Name): WILLIAM HOWARD HARRIS OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 LAKEHURST DR SUITE 177
ORLANDO FL
32819-8345
US

IV. Provider business mailing address

2445 ALCLOBE CIR
OCOEE FL
34761-8970
US

V. Phone/Fax

Practice location:
  • Phone: 407-903-7888
  • Fax: 407-903-7888
Mailing address:
  • Phone: 407-234-6954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT005297
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: