MEDICARE: HARRY KOLODNER 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	332H00000X	Eyewear Supplier	ME33861	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME33861	OTHER	FL	FLORIDA MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750569349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRY KOLODNER MD

Provider Business Mailing Address
First Line	:	PO BOX 987
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-0987
Country	:	US
Telephone Number	:	727-786-0906
Fax Number	:	727-781-4788

Provider Business Practice Location Address
First Line	:	33920 US HIGHWAY 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-2654
Country	:	US
Telephone Number	:	727-786-0906
Fax Number	:	727-781-4788

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	HARRY KOLODNER
Credential	:	MD
Telephone Number	:	727-786-0906

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	02/06/2008

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