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Individual

DR. TANIKA RAE-ANN HARLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1680 SE LYNGATE DR STE 201, PORT SAINT LUCIE, FL 34952-4300
(772) 210-3339
(772) 404-7819
Mailing address
1680 SE LYNGATE DR STE 201, PORT SAINT LUCIE, FL 34952-4300
(772) 210-3339
(772) 404-7819

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO3923
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1801280862
NPI
FL
Enumeration date
03/26/2015
Last updated
10/07/2021
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