MEDICARE: MAUIRCE HARDEN CNA, M.S

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	376K00000X	Nurse's Aide	CNA356098	FL

General Provider Information

NPI Number	:	1568843746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUIRCE HARDEN CNA, M.S

Provider Business Mailing Address
First Line	:	9811 GREENWAY GARDEN CT APT 301
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7056
Country	:	US
Telephone Number	:	813-992-4274
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 W FLETCHER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-3400
Country	:	US
Telephone Number	:	813-605-0191
Fax Number	:

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

Provider Enumeration Date	:	06/14/2015
Last Update Date	:	03/17/2018

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