Provider Demographics
NPI:1881643195
Name:HARRIS, SYLVIA V (MD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:V
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:PO BOX 6211
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-0211
Mailing Address - Country:US
Mailing Address - Phone:517-442-5000
Mailing Address - Fax:
Practice Address - Street 1:5151 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504
Practice Address - Country:US
Practice Address - Phone:850-416-7619
Practice Address - Fax:850-416-7753
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086892207R00000X
FLME75022207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
04899OtherPARAMOUNT
7134126OtherAETNA
FL007157800Medicaid
AL210864Medicaid
MI4849157Medicaid
37635OtherHPM
1104610781OtherBCBS MI
P00603530OtherRRMC
000000391413OtherANTHEM
153486OtherGLHP