Provider Demographics
NPI:1447281282
Name:HARNEY, CHARLES LEE (AUDIOLOGIST)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LEE
Last Name:HARNEY
Suffix:
Gender:M
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10455 RIVERSIDE DR.
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-478-8770
Mailing Address - Fax:561-598-7230
Practice Address - Street 1:3134 LAKE WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934
Practice Address - Country:US
Practice Address - Phone:321-254-9919
Practice Address - Fax:787-722-0015
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR103231H00000X
FL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2322OtherINTERNATIONAL MEDICAL CAR
PR451710OtherCIGNA
PR660-38-4383OtherMCS
PR250000OtherUTI
PR660-38-4383OtherCANADA LIFE
PR660-38-4383OtherTRICARE
PR450004OtherHUMANA HEALTH
PRAD-00103OtherUIA
PR660-38-4383OtherPALIC
PR660384383OtherFIRST PLUS
PR0064012Medicare ID - Type Unspecified