MEDICARE: RILEY HARMS

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	363AS0400X	Surgical Physician Assistant

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	:	1649782384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RILEY HARMS

Provider Business Mailing Address
First Line	:	10740 PALM RIVER RD STE 300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4577
Country	:	US
Telephone Number	:	813-651-3300
Fax Number	:	813-651-4455

Provider Business Practice Location Address
First Line	:	10740 PALM RIVER RD STE 300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4577
Country	:	US
Telephone Number	:	813-651-3300
Fax Number	:	813-651-4455

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

Provider Enumeration Date	:	11/03/2017
Last Update Date	:	11/03/2017

Similar Medicare Providers

1861321820 — STEPHANIE ROSE LINTON DPT
Practice Location Address:

10740 PALM RIVER RD STE 310
TAMPA, FL
33619-4577

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1164952552 — RYAN BURKE DPT
Practice Location Address:

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33619-4577

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1275020414 — ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA
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1760979140 — ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA
Practice Location Address:

10740 PALM RIVER RD STE 310
TAMPA, FL
33619-4577

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1518599935 — WILLIAM LAGROSA APRN
Practice Location Address:

10740 PALM RIVER RD STE 300
TAMPA, FL
33619-4577

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Practice Fax:

1336920917 — TAMPA GENERAL MEDICAL GROUP INC
Practice Location Address:

10740 PALM RIVER RD STE 300
TAMPA, FL
33619-4577

Practice Phone: 813-844-8910
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Directions to “ RILEY HARMS ” Practice Location

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