Healthcare Provider Details

I. General information

NPI: 1164413589
Provider Name (Legal Business Name): WILLIAM N. HARWIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14270 ROYAL HARBOUR CT UNIT 1021
FORT MYERS FL
33908-6577
US

IV. Provider business mailing address

14270 ROYAL HARBOUR CT UNIT 1021
FORT MYERS FL
33908-6577
US

V. Phone/Fax

Practice location:
  • Phone: 239-485-2083
  • Fax:
Mailing address:
  • Phone: 239-485-2083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME35430
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME35430
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: