Provider Demographics
NPI:1912287392
Name:HARRIS, KEMOY KARYL (MD)
Entity type:Individual
Prefix:DR
First Name:KEMOY
Middle Name:KARYL
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W GORE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1008
Mailing Address - Country:US
Mailing Address - Phone:321-841-8555
Mailing Address - Fax:218-412-4253
Practice Address - Street 1:207 W GORE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1008
Practice Address - Country:US
Practice Address - Phone:321-841-8555
Practice Address - Fax:218-412-4253
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138538207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101534300Medicaid