MEDICARE: LARJAR

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	171R00000X	Interpreter
2	172A00000X	Driver
3	251E00000X	Home Health Agency
4	251F00000X	Home Infusion Agency
5	332B00000X	Durable Medical Equipment & Medical Supplies
6	332BC3200X	Customized Equipment (DME)
7	332BX2000X	Oxygen Equipment & Supplies (DME)
8	332S00000X	Hearing Aid Equipment
9	335E00000X	Prosthetic/Orthotic Supplier
10	347E00000X	Transportation Broker	P07000002637	FL

General Provider Information

NPI Number	:	1548604614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARJAR

Provider Business Mailing Address
First Line	:	4710 EISENHOWER BLVD
Second Line	:	STE C-2
City	:	TAMPA
State	:	FL
Zip	:	33511
Country	:	US
Telephone Number	:	813-769-3886
Fax Number	:	813-769-3883

Provider Business Practice Location Address
First Line	:	4710 EISENHOWER BLVD STE C2
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-6334
Country	:	US
Telephone Number	:	813-769-3880
Fax Number	:	813-769-3883

Authorized Official
Title or Position	:	CEO
Name	:	CORTLAND REILLY
Credential	:
Telephone Number	:	813-769-3890

Provider Enumeration Date	:	04/19/2013
Last Update Date	:	07/22/2025

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Directions to “LARJAR ” Practice Location

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