Healthcare Provider Details

I. General information

NPI: 1124013388
Provider Name (Legal Business Name): PAMELA LARCADA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SUNSET DR SUITE 351
MIAMI FL
33173-3012
US

IV. Provider business mailing address

10300 SUNSET DR SUITE 351
MIAMI FL
33173-3012
US

V. Phone/Fax

Practice location:
  • Phone: 305-273-1200
  • Fax: 305-273-1400
Mailing address:
  • Phone: 305-273-1200
  • Fax: 305-273-1400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME43793
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: