Individual
HARSHAL ATHALYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6373
Mailing address
5672 INFINITY LN UNIT 414, VIRGINIA BEACH, VA 23464-8286
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD61377700
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72570901
DRIVERS LICENSE DMV
VT
05
—
90000VT1000001
—
VT
Enumeration date
03/25/2020
Last updated
06/12/2023
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