Provider Demographics
NPI:1851906077
Name:HARRIS, BRITTANY JUNE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JUNE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 SW EASTPORT CIR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-7125
Mailing Address - Country:US
Mailing Address - Phone:561-809-8683
Mailing Address - Fax:
Practice Address - Street 1:331 SW EASTPORT CIR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-7125
Practice Address - Country:US
Practice Address - Phone:561-809-8683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies