MEDICARE: MARIA SOLEDAD HARNISTH 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	208000000X	Pediatrics Physician	ME104597	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225263957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA SOLEDAD HARNISTH MD

Provider Business Mailing Address
First Line	:	900 S PINE ISLAND RD STE 800
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3923
Country	:	US
Telephone Number	:	954-414-7700
Fax Number	:	954-840-0850

Provider Business Practice Location Address
First Line	:	5810 CORAL RIDGE DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3374
Country	:	US
Telephone Number	:	954-414-7700
Fax Number	:	954-840-0850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	01/10/2020

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