MEDICARE: HARMONY LACTATION CONSULTING LLC

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	163WL0100X	Lactation Consultant (Registered Nurse)	1053452	FL

General Provider Information

NPI Number	:	1366871105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMONY LACTATION CONSULTING LLC

Provider Business Mailing Address
First Line	:	3311 GULF BREEZE PKWY
Second Line	:	PMB#345
City	:	GULF BREEZE
State	:	FL
Zip	:	32563-3351
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3311 GULF BREEZE PKWY
Second Line	:	PMB#345
City	:	GULF BREEZE
State	:	FL
Zip	:	32563-3351
Country	:	US
Telephone Number	:	850-293-1265
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ELAINE CONDON
Credential	:	RN, IBCLC-RLC
Telephone Number	:	850-293-1265

Provider Enumeration Date	:	11/02/2013
Last Update Date	:	11/02/2013

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