Provider Demographics
NPI:1124776802
Name:DORSEY, HARRY THOMAS (HAS)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:THOMAS
Last Name:DORSEY
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6092 FOREST VILLAS CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4532
Mailing Address - Country:US
Mailing Address - Phone:914-755-2639
Mailing Address - Fax:
Practice Address - Street 1:2310 TAMIAMI TRL UNIT 3109
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-5935
Practice Address - Country:US
Practice Address - Phone:941-575-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-12
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5145237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist