Individual
MR. LEO TIMOTHY HARRIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-8888
Mailing address
300 NE 57TH ST, MIAMI, FL 33137-2543
(305) 610-1504
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102129
FL
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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