Provider Demographics
NPI:1487849600
Name:HARRIS, ANNA MICHELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MICHELLE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1875 FORTUNE RD
Mailing Address - Street 2:BLDG 2
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4428
Mailing Address - Country:US
Mailing Address - Phone:407-943-8600
Mailing Address - Fax:407-932-5140
Practice Address - Street 1:1875 FORTUNE RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4428
Practice Address - Country:US
Practice Address - Phone:407-343-2000
Practice Address - Fax:407-343-2002
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY222518-1207Q00000X
FLOS11429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine