Individual
MR. MICHAEL DALE HARLESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11836 LAKEWOOD DR, HUDSON, FL 34669
(727) 379-9663
Mailing address
9133 BARRINGTON LN, PORT RICHEY, FL 34668-5102
(727) 967-5467
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
692668179
—
FL
Enumeration date
04/08/2009
Last updated
04/08/2009
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