Basic Information
| Provider Information | |||||||||
| NPI: | 1770501124 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARLEY | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 S ROYAL POINCIANA BLVD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MIAMI SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331666600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058051700 | ||||||||
| FaxNumber: | 3059941484 | ||||||||
| Practice Location | |||||||||
| Address1: | 7200 NW 22ND AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331476222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058358122 | ||||||||
| FaxNumber: | 3056922083 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 09/21/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | ARNP1520512 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
ID Information
| ID | Type | State | Issuer | Description | 306831501 | 05 | FL | MEDICAID | 306831500 | 05 | FL | MEDICAID | U7058 | 01 | FL | BCBS | OTHER |