Provider Demographics
NPI:1013920032
Name:CHIRON, HARLAN S (MD)
Entity Type:Individual
Prefix:
First Name:HARLAN
Middle Name:S
Last Name:CHIRON
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 1:4675 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2113
Mailing Address - Country:US
Mailing Address - Phone:350-663-4649
Mailing Address - Fax:305-663-4113
Practice Address - Street 1:4675 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2113
Practice Address - Country:US
Practice Address - Phone:350-663-4649
Practice Address - Fax:305-663-4113
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMEOO15743207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71057YMedicare ID - Type UnspecifiedMEDICARE
FLD57944Medicare UPIN