Healthcare Provider Details

I. General information

NPI: 1336155233
Provider Name (Legal Business Name): CHRISTINE E LARSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 7TH AVE N
ST PETERSBURG FL
33705-1300
US

IV. Provider business mailing address

800 2ND AVE S STE 340
ST PETERSBURG FL
33701-4206
US

V. Phone/Fax

Practice location:
  • Phone: 727-896-3134
  • Fax: 727-827-5155
Mailing address:
  • Phone: 727-896-3134
  • Fax: 727-827-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberME0064300
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberME0064300
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberME0064300
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME0064300
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME0064300
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberME0064300
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: