Healthcare Provider Details

I. General information

NPI: 1184731622
Provider Name (Legal Business Name): HARRY C MIDGLEY III MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 BURNS RD STE 104
PALM BEACH GARDENS FL
33410-4354
US

IV. Provider business mailing address

241 OCEAN DR
TEQUESTA FL
33469-3523
US

V. Phone/Fax

Practice location:
  • Phone: 561-691-4144
  • Fax: 561-743-7195
Mailing address:
  • Phone: 561-346-7373
  • Fax: 561-743-7195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number39600
License Number StateFL

VIII. Authorized Official

Name: DR. HARRY C MIDGLEY III
Title or Position: PRESIDENT
Credential: MD
Phone: 561-346-3469