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General NPI Number Information
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NPI Number | 1013172295
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Entity Type | Organization
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Legal Business Name | LARRY QUIRIT, M.D., P.A.
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Dates
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Enumeration Date | 07/27/2008
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Last Update Date | 07/27/2008
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Provider Practice Location Address
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Address Line | 1810 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5545
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Country | US
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Telephone | 772-398-0043
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Fax | 772-398-4914
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Provider Business Mailing Address
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Address Line | 1810 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5545
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Country | US
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Telephone | 772-398-0043
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Fax | 772-398-4914
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARRY FENOL QUIRIT
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Credential | M.D.
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Telephone | 772-398-0043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME47876
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License Number State | FL
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