Provider Demographics
NPI:1942579933
Name:DR. HARRISON R. PRATER, D.C., P.A.
Entity Type:Organization
Organization Name:DR. HARRISON R. PRATER, D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:R
Authorized Official - Last Name:PRATER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-290-6503
Mailing Address - Street 1:7601 CONROY WINDERMERE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-2689
Mailing Address - Country:US
Mailing Address - Phone:407-290-6503
Mailing Address - Fax:407-292-5270
Practice Address - Street 1:7601 CONROY WINDERMERE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-2689
Practice Address - Country:US
Practice Address - Phone:407-290-6503
Practice Address - Fax:407-292-5270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4188261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT95189Medicare UPIN