Provider Demographics
NPI:1013368257
Name:HARBESON, CARMELITA LESLIE (DPM)
Entity Type:Individual
Prefix:
First Name:CARMELITA
Middle Name:LESLIE
Last Name:HARBESON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 N PALAFOX ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1721
Mailing Address - Country:US
Mailing Address - Phone:850-433-5488
Mailing Address - Fax:850-434-9086
Practice Address - Street 1:2110 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501
Practice Address - Country:US
Practice Address - Phone:850-433-5488
Practice Address - Fax:850-434-9086
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006745213ES0103X
FLPO4085213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery