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General NPI Number Information
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NPI Number | 1861909988
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Entity Type | Organization
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Legal Business Name | HARRIS FAMILY EYE CARE
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 2186 HARRIS AVE NE STE 1
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City | PALM BAY
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State | FL
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Zip | 32905-4044
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Country | US
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Telephone | 321-724-2020
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Fax | 321-724-9088
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Provider Business Mailing Address
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Address Line | 11304 SW BARTON WAY
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987-2789
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Country | US
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Telephone | 908-304-4852
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Fax |
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Authorized Official
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Title or Position | CEO/OD
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Name | BRIAN HARRIS
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Credential | OD
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Telephone | 321-724-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC5202
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | OPC5202
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC5202
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License Number State | FL
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