Provider Demographics
NPI:1114982717
Name:HARMON, CLAUDE A (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:A
Last Name:HARMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:10141 W FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6103
Practice Address - Country:US
Practice Address - Phone:561-793-6500
Practice Address - Fax:561-798-0619
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME391792085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP970985OtherOPTIMUM
FL4553131OtherAETNA
FLP01560960OtherRR MEDICARE
FL209139OtherAVMED
FL232282OtherWELLCARE
PA101548107Medicaid
FL96772OtherBCBS
FLP999240OtherFREEDOM
FL4014OtherDIMENSION HEALTH PPO
FL209139OtherAVMED
FL96772NMedicare PIN
FLP999240OtherFREEDOM
PA100436UAOMedicare PIN