Provider Demographics
NPI:1639147036
Name:HARRIS, DAVID PM (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PM
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 25487
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2487
Mailing Address - Country:US
Mailing Address - Phone:941-371-3500
Mailing Address - Fax:855-253-4836
Practice Address - Street 1:5831 BEE RIDGE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5088
Practice Address - Country:US
Practice Address - Phone:941-379-8481
Practice Address - Fax:941-379-3781
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58389207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054833200Medicaid
FL11293OtherBCBS
FL11293OtherBCBS
FL11293VMedicare PIN
FL11293WMedicare PIN