Provider Demographics
NPI:1619645108
Name:LOVINSKY, HARISON DORICENT
Entity Type:Individual
Prefix:
First Name:HARISON
Middle Name:DORICENT
Last Name:LOVINSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 SW 28TH CT
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1200
Mailing Address - Country:US
Mailing Address - Phone:954-687-4373
Mailing Address - Fax:
Practice Address - Street 1:13000 SW 28TH CT
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-1200
Practice Address - Country:US
Practice Address - Phone:954-687-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities