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General NPI Number Information
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NPI Number | 1770884009
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Entity Type | Organization
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Legal Business Name | IRA HARMON MD PA
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 5685 NORWOOD AVE
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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 | 904-765-8838
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Fax | 904-765-8839
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Provider Business Mailing Address
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Address Line | 5685 NORWOOD AVE
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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 | 904-765-8838
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Fax | 904-765-8839
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Authorized Official
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Title or Position | OWNER
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Name | IRA HARMON
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Credential | MD
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Telephone | 904-765-8838
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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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