Provider Demographics
NPI:1891144911
Name:HANLON, JENNIFER HARB (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HARB
Last Name:HANLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:HARB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15280 NW 79TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5873
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:786-907-4485
Practice Address - Street 1:13101 S DIXIE HWY STE 310
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-6530
Practice Address - Country:US
Practice Address - Phone:305-666-2722
Practice Address - Fax:305-822-5860
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA267039207Y00000X
FLME148287207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology