Provider Demographics
NPI:1992774566
Name:HARMON, JON ALAN (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:ALAN
Last Name:HARMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 862811
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-2811
Mailing Address - Country:US
Mailing Address - Phone:913-754-0467
Mailing Address - Fax:913-341-5797
Practice Address - Street 1:711 S PARSONS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6058
Practice Address - Country:US
Practice Address - Phone:813-654-7111
Practice Address - Fax:813-654-3347
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49710207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11666OtherBCBS OF FL
FL052696700Medicaid
FL050029977OtherRAILROAD MEDICARE
FL052696700Medicaid
FL11666ZMedicare PIN