Larson, Kenneth Andrew
Larson, Kenneth Andrew is an individual health care provider with primary practice located at 5511 S Congress Ave Suite 105, Atlantis FL 33462-1140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Larson, Kenneth Andrew can be contacted via phone (561) 964-1635.Contact Information
Primary practice address
5511 S Congress Ave Suite 105
Atlantis FL 33462-1140
Phone: (561) 964-1635
Fax: (561) 964-1636
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ME088693 | Florida |
Profile Details
| NPI number | 1659451441 |
|---|---|
| LBN Legal business name | Larson, Kenneth Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2006 |
| Last updated | Feb 11th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659451441 | NPPES |
| Florida | MEDICAID | 270211800 |
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