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General NPI Number Information
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NPI Number | 1366460032
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Entity Type | Individual
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Provider Name | IRA HARMON MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 580 W 8TH ST SUITE 6017
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6533
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Country | US
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Telephone | 904-354-0622
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Fax | 904-354-0623
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Provider Business Mailing Address
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Address Line | 5685 NORWOOD AVE SUITE 6017
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City | JACKSONVILLE
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State | FL
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Zip | 32208-5012
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Country | US
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Telephone | 904-354-0622
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Fax | 904-354-0623
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0033826
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License Number State | FL
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