Healthcare Provider Details

I. General information

NPI: 1467684381
Provider Name (Legal Business Name): MICHELLE M HARMON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE M WILLIAMS PT

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 05/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TAMIAMI TRL S 210
VENICE FL
34285-2614
US

IV. Provider business mailing address

4457 DIAMOND CIR S
SARASOTA FL
34233-2065
US

V. Phone/Fax

Practice location:
  • Phone: 941-483-3400
  • Fax: 941-483-3422
Mailing address:
  • Phone: 832-443-5260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT24823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: