Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME111506 | FL |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | ME111506 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME111506 | FL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME111506 | FL |
N | 207XX0801X | Orthopaedic Trauma Surgeon | ME111506 | FL |
NPI | 1952688392 |
---|---|
Provider Name | Dr. Matthew J Harris |
First Address | Jupiter, FL 33477 |
Second Address | Jupiter, FL 33477 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2011 |
Last Update Date | 31/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018057900 | (05) | FL |