Ertel, Larry L

Ertel, Larry L is an individual health care provider with primary practice located at 620 10Th St N Ste 1D , Saint Petersburg FL 33705-1407. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Ertel, Larry L can be contacted via phone (727) 824-7161.

Contact Information

Primary practice address
620 10Th St N Ste 1D Saint Petersburg FL 33705-1407
Phone: (727) 824-7161
Fax: (727) 824-7163
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35650 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35650 Kentucky

Profile Details

NPI number 1063479954
LBN Legal business name Ertel, Larry L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jan 13th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063479954 NPPES
Kentucky MEDICAID 64012636

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