Individual
MR. LONNIE RAY HARDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5129 STATE ROAD 674, SUITE A, WIMAUMA, FL 33598-3530
(813) 633-8489
(813) 633-2669
Mailing address
5129 STATE ROAD 674, SUITE A, WIMAUMA, FL 33598-3530
(813) 633-8489
(813) 633-2669
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2166
FL
363AM0700X
Medical Physician Assistant
PA2166
FL
363AS0400X
Surgical Physician Assistant
Primary
PA2166
FL
Other
Enumeration date
07/12/2005
Last updated
09/11/2025
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