Provider Demographics
NPI:1740427079
Name:HARRIS, MICHAEL DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DENNIS
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR STE 500
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-6600
Mailing Address - Country:US
Mailing Address - Phone:813-615-7028
Mailing Address - Fax:813-615-8008
Practice Address - Street 1:3000 MEDICAL PARK DR STE 500
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-6600
Practice Address - Country:US
Practice Address - Phone:813-615-7028
Practice Address - Fax:813-615-8008
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241889-1207RG0100X
FLME106999207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology