Individual
JUSTIN WILLIAM HARLACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5216 CLAYTON CT, FORT MYERS, FL 33907-2116
(239) 343-8260
(239) 424-2442
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-8260
(239) 343-8261
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110049
FL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019437800
—
FL
Enumeration date
10/17/2016
Last updated
09/04/2020
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