Provider Demographics
NPI:1699737627
Name:HARDING, HERNDON PRICE JR (MD)
Entity type:Individual
Prefix:
First Name:HERNDON
Middle Name:PRICE
Last Name:HARDING
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 CASA ALOMA WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2223
Mailing Address - Country:US
Mailing Address - Phone:407-671-0057
Mailing Address - Fax:
Practice Address - Street 1:2828 CASA ALOMA WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2223
Practice Address - Country:US
Practice Address - Phone:407-671-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME747942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL571138572OtherCIGNA
FL57-1138572OtherCIGNA BEHAVIORAL HEALTH
FL254578100Medicaid
FL57-1138572OtherWALT DISNEY WORKERS COMP
FL57-1138572OtherBEECHSTREET
FL571138572OtherUNITED BEHAVIORAL HEALTH
FL57-1138572OtherPRIVARE HEALTHCARE SYSTEM
FL42609OtherBCBS FLORIDA
FL42609OtherBCBS FLORIDA
FL57-1138572OtherBEECHSTREET