Healthcare Provider Details

I. General information

NPI: 1922086875
Provider Name (Legal Business Name): HAKAN CHARLES-HARRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2006
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 NW 95TH ST SUITE 101
MIAMI FL
33150-2063
US

IV. Provider business mailing address

1190 NW 95TH ST SUITE 101
MIAMI FL
33150-2063
US

V. Phone/Fax

Practice location:
  • Phone: 305-691-2941
  • Fax: 305-696-4435
Mailing address:
  • Phone: 305-691-2941
  • Fax: 305-696-4435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME81121
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: