Basic Information
Provider Information
NPI: 1629580683
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARDMAN
FirstName: VERONICA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1800 SE 17TH ST STE 100
Address2:  
City: OCALA
State: FL
PostalCode: 344714113
CountryCode: US
TelephoneNumber: 3523514999
FaxNumber: 3523518106
Practice Location
Address1: 1800 SE 17TH ST STE 100
Address2:  
City: OCALA
State: FL
PostalCode: 344714113
CountryCode: US
TelephoneNumber: 3523514999
FaxNumber: 3523518106
Other Information
ProviderEnumerationDate: 10/31/2017
LastUpdateDate: 02/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN9296893FLN Nursing Service ProvidersRegistered Nurse 
363LF0000XARNP9296893FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home