Provider Demographics
NPI:1922241900
Name:BERMUDEZ, HARLEM A
Entity Type:Individual
Prefix:
First Name:HARLEM
Middle Name:A
Last Name:BERMUDEZ
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 1:13962 SW 260 STREET
Mailing Address - Street 2:UNIT 105
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032
Mailing Address - Country:US
Mailing Address - Phone:786-543-9983
Mailing Address - Fax:
Practice Address - Street 1:13962 SW 260TH ST
Practice Address - Street 2:UNIT 105
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-6605
Practice Address - Country:US
Practice Address - Phone:786-543-9983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst