MEDICARE: MR. LARRY PHILIP GARRETT 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	207Q00000X	Family Medicine Physician	ME11144	FL

General Provider Information

NPI Number	:	1588087076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LARRY PHILIP GARRETT M.D.

Provider Business Mailing Address
First Line	:	3543 STUART CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901
Country	:	US
Telephone Number	:	239-334-4696
Fax Number	:

Provider Business Practice Location Address
First Line	:	3543 STUART CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901
Country	:	US
Telephone Number	:	239-334-4696
Fax Number	:

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

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	02/04/2014

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