Provider Demographics
NPI:1528898723
Name:HARNEY, EMILIN M
Entity type:Individual
Prefix:
First Name:EMILIN
Middle Name:M
Last Name:HARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 LITHIA PINECREST RD STE A
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5346
Mailing Address - Country:US
Mailing Address - Phone:813-381-6131
Mailing Address - Fax:
Practice Address - Street 1:121 LITHIA PINECREST RD STE A
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5346
Practice Address - Country:US
Practice Address - Phone:813-381-6131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-03
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA102449225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist