Larsen, Richard A

Larsen, Richard A is an individual health care provider with primary practice located at 13778 Plantation Rd , Fort Myers FL 33912-4301. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Larsen, Richard A can be contacted via phone (239) 343-0454.

Contact Information

Primary practice address
13778 Plantation Rd Fort Myers FL 33912-4301
Fax: (239) 343-1078
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA0003376 Florida

Profile Details

NPI number 1144292194
LBN Legal business name Larsen, Richard A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Mar 29th, 2021 - about 3 years ago

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 1144292194 NPPES
Florida MEDICAID 014924700

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