MEDICARE: DR. LARRY A HAWKINS D.C.

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	111N00000X	Chiropractor	CH8758	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	76064	OTHER	FL	FLORIDA BLUE

General Provider Information

NPI Number	:	1841387404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY A HAWKINS D.C.

Provider Business Mailing Address
First Line	:	6655 LAKE WORTH RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1507
Country	:	US
Telephone Number	:	561-707-8212
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 LAKE WORTH RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1507
Country	:	US
Telephone Number	:	561-707-8212
Fax Number	:

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/03/2022

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