Provider Demographics
NPI:1497723050
Name:HARRINGTON, ALLAN CRANE (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:CRANE
Last Name:HARRINGTON
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 1:16461 DOMESTIC AVE STE M
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-6008
Mailing Address - Country:US
Mailing Address - Phone:772-667-7688
Mailing Address - Fax:603-952-3900
Practice Address - Street 1:16461 DOMESTIC AVE STE M
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-6008
Practice Address - Country:US
Practice Address - Phone:772-667-7688
Practice Address - Fax:603-952-3900
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043495207N00000X, 207ND0101X
FLME148028207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD224001700Medicaid
MD224001700Medicaid
MDE30159Medicare UPIN