Individual
BLAIRE FARRIOR HARROLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2908 W AZEELE ST, TAMPA, FL 33609-3110
(813) 278-1012
Mailing address
4616 W INGRAHAM ST, TAMPA, FL 33616-2120
(813) 470-9715
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11009624
FL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
11009624
FL
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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