MEDICARE: DR. ANTHONY MICHAEL 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	207X00000X	Orthopaedic Surgery Physician	ME94420	FL
2	207XX0801X	Orthopaedic Trauma Physician	ME94420	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	:	1902867468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY MICHAEL HARRIS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 370
Second Line	:
City	:	FORTSON
State	:	GA
Zip	:	31808-0370
Country	:	US
Telephone Number	:
Fax Number	:	706-494-3008

Provider Business Practice Location Address
First Line	:	309 N MANGOUSTINE AVE UNIT G
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32771-1098
Country	:	US
Telephone Number	:	321-363-1754
Fax Number	:	321-363-3336

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	03/06/2025

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