MEDICARE: MRS. GAIL LOUISE HARRIS LCSW

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	1041C0700X	Clinical Social Worker	SW0002489	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	:	1972588135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GAIL LOUISE HARRIS LCSW

Provider Business Mailing Address
First Line	:	975 ARTHUR GODFREY RD STE 303
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3342
Country	:	US
Telephone Number	:	786-210-4814
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 ARTHUR GODFREY RD STE 303
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3342
Country	:	US
Telephone Number	:	305-864-7662
Fax Number	:

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

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	09/23/2021

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