Provider Demographics
NPI:1871209916
Name:HARMONY MEDICAL CLINIC
Entity type:Organization
Organization Name:HARMONY MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-906-1332
Mailing Address - Street 1:1948 SAXON BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-4582
Mailing Address - Country:US
Mailing Address - Phone:386-774-7246
Mailing Address - Fax:
Practice Address - Street 1:1948 SAXON BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-4582
Practice Address - Country:US
Practice Address - Phone:386-774-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1033405345OtherDR. HERMAN LESTER CARRERO
FL1134512387OtherHARMONY CLINIC