Provider Demographics
NPI:1467684381
Name:HARMON, MICHELLE M (DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:HARMON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:M
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4457 DIAMOND CIR S
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2065
Mailing Address - Country:US
Mailing Address - Phone:832-443-5260
Mailing Address - Fax:
Practice Address - Street 1:400 TAMIAMI TRL S
Practice Address - Street 2:210
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2614
Practice Address - Country:US
Practice Address - Phone:941-483-3400
Practice Address - Fax:941-483-3422
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24823225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT24823OtherPT LICENSE