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NPI 1720315369

NPI 1720315369 : ADRIANE L HARRIS : ZEPHYRHILLS, FL

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General NPI Number Information
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    NPI Number           |    1720315369
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    Entity Type          |    Individual 
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    Provider Name        |    ADRIANE L HARRIS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/03/2009
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    Last Update Date     |    06/18/2024
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Provider Practice Location Address
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    Address Line         |    38101 MARKET SQUARE DR 
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    City                 |    ZEPHYRHILLS
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    State                |    FL
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    Zip                  |    33542-7505
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    Country              |    US
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    Telephone            |    813-715-0195
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    Fax                  |    813-355-5049
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Provider Business Mailing Address
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    Address Line         |    38135 MARKET SQUARE DR 
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    City                 |    ZEPHYRHILLS
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    State                |    FL
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    Zip                  |    33542-7505
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    Country              |    US
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    Telephone            |    352-567-0188
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    Fax                  |    
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    27OA00600300
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    License Number State |    NJ
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Taxonomy #2
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    OPC6076
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    License Number State |    FL
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