Organization
JON A HARMON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN T MASIELLO MD (AUTHORIZED OFFICIAL)
(813) 654-7771
Entity
Organization
Contact information
Practice address
711 S PARSONS AVE, BRANDON, FL 33511-6058
(813) 654-7771
(913) 696-7141
Mailing address
PO BOX 862811, ORLANDO, FL 32886-2811
(800) 884-7205
(913) 696-7141
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379556000
—
FL
01
—
39298
BCBS
FL
01
—
CC4705
RAILROAD MEDICARE
FL
Enumeration date
04/06/2006
Last updated
09/12/2019
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