Provider Demographics
NPI:1508986035
Name:HARRISON, ROBERT ALAN (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALAN
Last Name:HARRISON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10540 SE 42ND TER
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-6856
Mailing Address - Country:US
Mailing Address - Phone:352-347-1503
Mailing Address - Fax:
Practice Address - Street 1:340 HEALD WAY STE 100
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163
Practice Address - Country:US
Practice Address - Phone:352-259-1919
Practice Address - Fax:352-259-1919
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 18357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist