Healthcare Provider Details
I. General information
NPI: 1497718571
Provider Name (Legal Business Name): HARRIS H MONES D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2645 S DOUGLAS RD SUITE 502
CORAL GABLES FL
33133-2754
US
IV. Provider business mailing address
2645 S DOUGLAS RD SUITE 502
CORAL GABLES FL
33133-2754
US
V. Phone/Fax
- Phone: 305-448-8942
- Fax: 305-445-2691
- Phone: 305-448-8942
- Fax: 305-445-2691
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | OS4172 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: