Provider Demographics
NPI:1790810265
Name:LERFELT, HARVEY (DC)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:LERFELT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 630062
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33163-0062
Mailing Address - Country:US
Mailing Address - Phone:305-932-8484
Mailing Address - Fax:
Practice Address - Street 1:15158 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33162-5034
Practice Address - Country:US
Practice Address - Phone:305-944-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004959111N00000X
MN2165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
55210OtherBLUE CROSS BLUE SHIELD