Basic Information
| Provider Information | |||||||||
| NPI: | 1609003896 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARVEY S MISHNER MD PL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7504 ABBEY GLN | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD RANCH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342022423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419070588 | ||||||||
| FaxNumber: | 9413736622 | ||||||||
| Practice Location | |||||||||
| Address1: | 11505 PALMBRUSH TRAIL | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | LAKEWOOD RANCH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342025183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419070588 | ||||||||
| FaxNumber: | 9413736622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2009 | ||||||||
| LastUpdateDate: | 09/09/2010 | ||||||||
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| AuthorizedOfficialLastName: | MISHNER | ||||||||
| AuthorizedOfficialFirstName: | HARVEY | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9419070588 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME84341 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.