MEDICARE: MISS SHATRIL HARRIS PHYSICIAN ASSISTANT

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	363AM0700X	Medical Physician Assistant	PA 9103425	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477505154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHATRIL HARRIS PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	2488 N UNIVERSITY DR
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-3624
Country	:	US
Telephone Number	:	954-983-9191
Fax Number	:	954-983-1152

Provider Business Practice Location Address
First Line	:	2488 N UNIVERSITY DR
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-3624
Country	:	US
Telephone Number	:	954-983-9191
Fax Number	:	954-983-1152

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	10/24/2007

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