Provider Demographics
NPI:1235570110
Name:HARRISON, CRAIG (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:HARRISON
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ATTENTION: KIM DURCAN
Mailing Address - Street 2:6700 N ANDREWS AVE STE 404
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-2165
Mailing Address - Country:US
Mailing Address - Phone:408-647-6334
Mailing Address - Fax:
Practice Address - Street 1:BROWARD GENERAL EMERGENCY DEPARTMENT
Practice Address - Street 2:1600 S ANDREWS AVE
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316
Practice Address - Country:US
Practice Address - Phone:408-647-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL130667207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty