MEDICARE: KAYLEE S HARLAN PA-C

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	363AM0700X	Medical Physician Assistant	9121286	FL

General Provider Information

NPI Number	:	1831049758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE S HARLAN PA-C

Provider Business Mailing Address
First Line	:	2755 E OAKLAND PARK BLVD STE 100
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1628
Country	:	US
Telephone Number	:	970-987-3373
Fax Number	:

Provider Business Practice Location Address
First Line	:	2755 E OAKLAND PARK BLVD STE 100
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1628
Country	:	US
Telephone Number	:	970-987-3373
Fax Number	:

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

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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