MEDICARE: DONALD P HARRELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME87462	FL

General Provider Information

NPI Number	:	1063637965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD P HARRELL MD

Provider Business Mailing Address
First Line	:	PO BOX 5576
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33045-5576
Country	:	US
Telephone Number	:	305-294-5731
Fax Number	:	305-294-5756

Provider Business Practice Location Address
First Line	:	1111 12TH ST STE 109
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-4087
Country	:	US
Telephone Number	:	305-294-5731
Fax Number	:	305-294-5756

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DONALD P HARRELL
Credential	:	MD
Telephone Number	:	305-294-5731

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	11/10/2009

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