Mrs. Marly Harlan PA-C, MPAS
Physician Assistant in Jacksonville, FL(View on Map)
Full Name
Mrs. Marly Harlan PA-C, MPAS
NPI Number
1417994799
NPI Type
Individual Provider
Gender
Female
Enumeration Date
06/02/2006
Specialties
(Taxonomies)Licenses
State
Florida
Iowa
License Number
PA9104139
001647
Contact
Information
Purpose
Mailing
Location
Address
4500 SAN PABLO RD S
4500 SAN PABLO RD S
City
Jacksonville
Jacksonville
State
FL
FL
Postal Code
32224-1865
32224-1865
Country
US
US
Telephone Number
(904) 953-2000
(904) 953-2000
Identifiers
Identifier
PA9104139
001647
AG592Z
Identifier State
FL
IA
FL
Identifier Issuer
STATE PA LICENSE
STATE PA MEDICAL LICENSE
MEDICARE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 12/26/2007