Provider Demographics
NPI:1013296110
Name:HARRIS, KAREN LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LEE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11995 SW ELSINORE DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-1907
Mailing Address - Country:US
Mailing Address - Phone:772-345-0225
Mailing Address - Fax:
Practice Address - Street 1:11995 SW ELSINORE DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-1907
Practice Address - Country:US
Practice Address - Phone:772-345-0225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist