Provider Demographics
NPI:1649782384
Name:HARMS, RILEY
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:HARMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10740 PALM RIVER RD STE 300
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4577
Mailing Address - Country:US
Mailing Address - Phone:813-651-3300
Mailing Address - Fax:813-651-4455
Practice Address - Street 1:10740 PALM RIVER RD STE 300
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4577
Practice Address - Country:US
Practice Address - Phone:813-651-3300
Practice Address - Fax:813-651-4455
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical