Provider Demographics
NPI:1003896424
Name:HARDING, CONSTANCE B
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:B
Last Name:HARDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 SW 27TH AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4741
Mailing Address - Country:US
Mailing Address - Phone:305-642-5255
Mailing Address - Fax:305-642-8850
Practice Address - Street 1:1250 SW 27TH AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4741
Practice Address - Country:US
Practice Address - Phone:305-642-5255
Practice Address - Fax:305-642-8850
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1093822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY072XAMedicare ID - Type Unspecified
FLQ44347Medicare UPIN