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Individual

CLARENCE M HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2023 PROFESSIONAL CENTER DRIVE, ORANGE PARK, FL 32073
(904) 272-2020
(904) 276-4386
Mailing address
2023 PROFESSIONAL CENTER DRIVE, ORANGE PARK, FL 32073
(904) 272-2020
(904) 276-4386

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0015120
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10075
BCBS
FL
01
1635739001
CIGNA
FL
01
4047763
AETNA
FL
01
CB1273
RAILROAD MEDICARE
FL
Enumeration date
04/19/2006
Last updated
10/24/2007
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