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General NPI Number Information
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NPI Number | 1609502657
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Entity Type | Individual
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Provider Name | JEZWAH E HARRIS FNP-BC, MEP-C, NE-BC
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Gender | Male
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Dates
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Enumeration Date | 07/30/2022
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 16215 BISCAYNE BLVD STE 131
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City | AVENTURA
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State | FL
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Zip | 33160-4300
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Country | US
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Telephone | 786-744-5152
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Fax | 786-685-2567
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Provider Business Mailing Address
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Address Line | 12555 BISCAYNE BLVD PMB 1037
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City | NORTH MIAMI
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State | FL
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Zip | 33181
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Country | US
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Telephone | 323-229-2070
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Fax | 786-685-2567
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 11035589
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 355285
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11035589
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11035589
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 11035589
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 314884
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License Number State | AZ
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95031847
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License Number State | CA
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