Healthcare Provider Details

I. General information

NPI: 1447757927
Provider Name (Legal Business Name): KATHRYN OLIVIA HARRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 CAPITAL MEDICAL BLVD STE 109C
TALLAHASSEE FL
32308-8417
US

IV. Provider business mailing address

2770 CAPITAL MEDICAL BLVD STE 109C
TALLAHASSEE FL
32308-8417
US

V. Phone/Fax

Practice location:
  • Phone: 850-877-0320
  • Fax:
Mailing address:
  • Phone: 850-877-0320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME181967
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD488273
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: