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General NPI Number Information
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NPI Number | 1871244848
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Entity Type | Individual
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Provider Name | HARISON RAFAEL PARRA MD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 3953 S NOVA RD STE A
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City | PORT ORANGE
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State | FL
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Zip | 32127-4910
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Country | US
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Telephone | 386-788-4911
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Fax | 844-388-6186
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Provider Business Mailing Address
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Address Line | 601 S HARBOUR ISLAND BLVD STE 200
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City | TAMPA
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State | FL
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Zip | 33602-5925
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Country | US
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Telephone | 727-322-3439
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1552
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 15705I
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License Number State | PR
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