Provider Demographics
NPI:1841680725
Name:HARRIS, RICHARD (CNA)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 26TH ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-3431
Mailing Address - Country:US
Mailing Address - Phone:727-439-0570
Mailing Address - Fax:
Practice Address - Street 1:2245 26TH ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-3431
Practice Address - Country:US
Practice Address - Phone:727-439-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital