Larson, Jacqueline Kay
Larson, Jacqueline Kay is an individual health care provider with primary practice located at 2 Tampa General Cir , Tampa FL 33606-3571. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as her primary health care specialty. Larson, Jacqueline Kay can be contacted via phone (813) 821-8038.Contact Information
Primary practice address
2 Tampa General Cir
Tampa FL 33606-3571
Phone: (813) 821-8038
Fax: (813) 974-0483
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | ME124534 | Florida |
Profile Details
| NPI number | 1386996759 |
|---|---|
| LBN Legal business name | Larson, Jacqueline Kay |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2012 |
| Last updated | Apr 24th, 2024 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386996759 | NPPES |
| Florida | MEDICAID | 101153100 | |
| Florida | Other | 76LDO |
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