Provider Demographics
NPI:1750315107
Name:HARRIS, JULIA K (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 HANCOCK BR PKWY
Mailing Address - Street 2:
Mailing Address - City:N FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-7094
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2625
Practice Address - Street 1:8803 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-3347
Practice Address - Country:US
Practice Address - Phone:239-732-1050
Practice Address - Fax:239-732-1054
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66788207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31537OtherFL BC
FL379581101Medicaid
FL31537Medicare PIN
FLG32374Medicare UPIN
FL31537OtherFL BC