MEDICARE: DELPHINE HARRISON

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1922510882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELPHINE HARRISON

Provider Business Mailing Address
First Line	:	PO BOX 667062
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33066-7062
Country	:	US
Telephone Number	:	954-224-2012
Fax Number	:

Provider Business Practice Location Address
First Line	:	2930 NW 20TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-3206
Country	:	US
Telephone Number	:	954-224-2012
Fax Number	:

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

Provider Enumeration Date	:	11/01/2017
Last Update Date	:	11/01/2017

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Directions to “ DELPHINE HARRISON ” Practice Location

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