Individual
HARLAN ERIC PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3301 OVERSEAS HWY, FISHERMEN'S HOSPITAL ANESTHESIA DEPT, MARATHON, FL 33050-2329
(305) 289-6407
(305) 289-6417
Mailing address
103 PIRATES CV, MARATHON, FL 33050-2925
(305) 743-0222
(305) 743-0114
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME62372
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME62372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050084607
RAILROAD MEDICARE
FL
01
—
17803
BLUE CROSS BLUE SHIELD FL
FL
05
—
370761000
—
FL
Enumeration date
05/11/2006
Last updated
09/04/2007
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