MEDICARE: RENEE HARRIS

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	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RBT-22-201931	OTHER		RBT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306507561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE HARRIS

Provider Business Mailing Address
First Line	:	515 LAKEVIEW DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34759-5319
Country	:	US
Telephone Number	:	321-361-0087
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 HERITAGE SQUARE DR
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-7844
Country	:	US
Telephone Number	:	407-533-3501
Fax Number	:	407-258-2754

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

Provider Enumeration Date	:	01/09/2022
Last Update Date	:	04/06/2026

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Directions to “ RENEE HARRIS ” Practice Location

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