MEDICARE: KURT N HARRIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME68508	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33310	OTHER	FL	BCBS GROUP
2	49436	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053308270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KURT N HARRIS M.D.

Provider Business Mailing Address
First Line	:	3820 TAMPA RD
Second Line	:	SUITE 202
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3609
Country	:	US
Telephone Number	:	727-785-4540
Fax Number	:	727-784-9724

Provider Business Practice Location Address
First Line	:	3820 TAMPA RD
Second Line	:	#202
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3609
Country	:	US
Telephone Number	:	727-785-4540
Fax Number	:	727-784-9724

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	02/18/2014

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