Provider Demographics
NPI:1043276892
Name:HARMON, MATTHEW LEVI (MA,ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:LEVI
Last Name:HARMON
Suffix:
Gender:M
Credentials:MA,ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5556 CENTURY 21 BLVD
Mailing Address - Street 2:APT 152
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-2130
Mailing Address - Country:US
Mailing Address - Phone:407-657-9592
Mailing Address - Fax:
Practice Address - Street 1:901 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3233
Practice Address - Country:US
Practice Address - Phone:407-206-1900
Practice Address - Fax:407-206-1928
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 16382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer