Provider Demographics
NPI:1164545273
Name:HARMON, LAWRENCE (PHD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:HARMON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 SOUTH DIXIE HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133
Mailing Address - Country:US
Mailing Address - Phone:305-285-8900
Mailing Address - Fax:305-285-1462
Practice Address - Street 1:2000 S DIXIE HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2456
Practice Address - Country:US
Practice Address - Phone:305-285-8900
Practice Address - Fax:305-285-1462
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3192103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR99895Medicare UPIN