Everett Harris
Individual provider Active NPI Physical Therapist · Heathrow, FL
NPI 1184807133 · NPPES record last updated Dec 13, 2007
Key facts
- NPI
- 1184807133
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 19820 (MD)
- Practice address
- 1485 International Pkwy
Heathrow, FL 32746-5303 - Phone
- (800) 798-6035
- NPI assigned
- Dec 13, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19820 | MD | MD | Pharmacotherapy Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 19820 | MD | Yes |
Addresses
Primary practice location
1485 International Pkwy
Heathrow, FL 32746-5303
Mailing address
1344 Turtle Dunes CT
Ponte Vedra Beach, FL 32082-6507
Phone (239) 682-5201
Other providers in Heathrow, FL
- Ruth Ellen Graves
- Tara Lea Green
- Tracy Ann Griffith
- Clarisa Stephanie Guerrero
- Chris Guthrie
- Brenda Nicole Hawkins
- Angela Hays
- Margaret Hogle
- Margaree Gaynell Hood
- Braden Hostetler
All providers in Heathrow, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.