Provider Demographics
NPI:1740479856
Name:HARAN, EILEEN H (ARNP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:H
Last Name:HARAN
Suffix:
Gender:F
Credentials:ARNP
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 901747
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33090-1747
Mailing Address - Country:US
Mailing Address - Phone:305-242-5620
Mailing Address - Fax:305-245-5294
Practice Address - Street 1:1532 FLAMINGO CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-1025
Practice Address - Country:US
Practice Address - Phone:305-242-5620
Practice Address - Fax:305-245-5294
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP534542163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90406ZMedicare PIN