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1427067248

NPI Code Detail

MEDICARE: DR. LARRY MATSUMOTO M.D.

MEDICARE: DR. LARRY MATSUMOTO 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
1	207VM0101X	Maternal & Fetal Medicine Physician	055424	GA
2	207VM0101X	Maternal & Fetal Medicine Physician	ME138959	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427067248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY MATSUMOTO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 863407
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32886-3407
Country	:	US
Telephone Number	:	941-917-2600
Fax Number	:	941-917-7884

Provider Business Practice Location Address
First Line	:	1888 HILLVIEW ST
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-3605
Country	:	US
Telephone Number	:	941-917-6260
Fax Number	:	941-917-6266

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	01/15/2019

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Directions to “ DR. LARRY MATSUMOTO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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