Provider Demographics
NPI:1013213081
Name:HARRIS, JENNI TAYLOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNI
Middle Name:TAYLOR
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 SAND LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7632
Mailing Address - Country:US
Mailing Address - Phone:407-856-2301
Mailing Address - Fax:407-851-0587
Practice Address - Street 1:1950 SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7632
Practice Address - Country:US
Practice Address - Phone:407-856-2301
Practice Address - Fax:407-851-0587
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47258183500000X
GA20908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist