MEDICARE: MS. ALTIA BEVERLY HARRIS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	372600000X	Adult Companion	FL
2	3747P1801X	Personal Care Attendant	FL
3	376J00000X	Homemaker	FL

General Provider Information

NPI Number	:	1922159987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALTIA BEVERLY HARRIS

Provider Business Mailing Address
First Line	:	171 NW 24TH CT
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-3214
Country	:	US
Telephone Number	:	954-941-3731
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 NW 24TH CT
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-3214
Country	:	US
Telephone Number	:	954-941-3731
Fax Number	:

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	09/11/2025

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