Brandon Lee Harris
Specialist in Port St Lucie, FL. Individual provider (NPI-1).
NPI number1164078267
StatusActive
Last updated in NPPESAug 14, 2019
Details
- NPI
- 1164078267
- Entity type
- Individual (NPI-1)
- Name
- Brandon Lee Harris
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 14, 2019
- Last updated
- Aug 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
1666 Sw Bayshore BlvdPort St Lucie, FL 34984-3568
Phone 772-446-9740
Mailing address
1666 Sw Bayshore BlvdPort St Lucie, FL 34984-3568
Phone 772-446-9740
Other practice locations
4025 20th St
Vero Beach, FL 32960-2403
Vero Beach, FL 32960-2403
Phone 772-569-0444
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