Provider Demographics
NPI:1194900845
Name:HARRIS, STEVEN ALBERT (LMT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ALBERT
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2074 CASCADES COVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32820-2238
Mailing Address - Country:US
Mailing Address - Phone:407-415-1136
Mailing Address - Fax:407-568-0869
Practice Address - Street 1:2074 CASCADES COVE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32820-2238
Practice Address - Country:US
Practice Address - Phone:407-415-1136
Practice Address - Fax:407-568-0869
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA22810225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist