Provider Demographics
NPI:1609878594
Name:HARTE, GARRETT L (DPM)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:L
Last Name:HARTE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-1335
Mailing Address - Country:US
Mailing Address - Phone:941-758-8818
Mailing Address - Fax:941-755-2901
Practice Address - Street 1:1800 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-1335
Practice Address - Country:US
Practice Address - Phone:941-758-8818
Practice Address - Fax:941-755-2901
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2610213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL480025956OtherRR INDIVIDUAL PROV. #
U65950Medicare UPIN
FL480025956OtherRR INDIVIDUAL PROV. #