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NPI Code Detail

MEDICARE: ANTONIO J LARRANAGA JR. M.D.

MEDICARE: ANTONIO J LARRANAGA JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianME67499FL

General Provider Information

NPI Number : 1073575320
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTONIO J LARRANAGA JR. M.D.
Provider Business Mailing Address
First Line : 11863 DELFINA LN
Second Line :
City : ORLANDO
State : FL
Zip : 32827-7105
Country : US
Telephone Number : 850-496-2727
Fax Number :
Provider Business Practice Location Address
First Line : 711 E OAK ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-4573
Country : US
Telephone Number : 407-846-0533
Fax Number : 407-518-1730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 08/21/2023

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