MEDICARE: KIRSTEN MARIE HARDER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	41646	FL

General Provider Information

NPI Number	:	1306461538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN MARIE HARDER

Provider Business Mailing Address
First Line	:	6900 DANIELS PKWY STE 19
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-1586
Country	:	US
Telephone Number	:	239-768-2210
Fax Number	:

Provider Business Practice Location Address
First Line	:	6900 DANIELS PKWY STE 19
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-1586
Country	:	US
Telephone Number	:	239-768-2210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2020
Last Update Date	:	06/12/2020

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Directions to “ KIRSTEN MARIE HARDER ” Practice Location

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