Healthcare Provider Details

I. General information

NPI: 1730535568
Provider Name (Legal Business Name): HAROLD ALEXANDER HAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 S. AMELIA AVE, UNIT #B
DELAND FL
32724
US

IV. Provider business mailing address

1888 PROSPECT AVE
ORLANDO FL
32814
US

V. Phone/Fax

Practice location:
  • Phone: 386-736-3322
  • Fax: 386-736-1133
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberASA774
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: