Provider Demographics
NPI:1316938293
Name:HARRIS, RACHEL M (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:1644 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-8600
Practice Address - Country:US
Practice Address - Phone:813-929-3600
Practice Address - Fax:813-355-5901
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.024226207Q00000X
FLME82511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01212433OtherR&R MEDICARE
FL270698900Medicaid
FL58976VMedicare PIN