Provider Demographics
NPI:1831178102
Name:HARROW, JEFFREY JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOHN
Last Name:HARROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14948 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-3298
Mailing Address - Country:US
Mailing Address - Phone:813-898-9829
Mailing Address - Fax:
Practice Address - Street 1:14948 LAKE FOREST DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-3298
Practice Address - Country:US
Practice Address - Phone:813-898-9829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT165540-8905207R00000X
NC9400828207R00000X, 2081P0004X
NMMD2017-0722207R00000X
FLME136877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMMD2017-0722OtherMEDICAL LICENSE
FLME136877OtherMEDICAL LICENSE
NC9400828OtherMEDICAL LICENSE
NC9400828OtherMEDICAL LICENSE