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General NPI Number Information
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NPI Number | 1356490619
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Entity Type | Organization
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Legal Business Name | LARRY C. DEEB, M.D., P.A.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 02/22/2016
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Provider Practice Location Address
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Address Line | 2804 REMINGTON GREEN CIR SUITE 1
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City | TALLAHASSEE
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State | FL
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Zip | 32308-1550
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Country | US
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Telephone | 850-878-0184
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Fax | 850-216-1537
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Provider Business Mailing Address
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Address Line | 2804 REMINGTON GREEN CIR SUITE 1
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City | TALLAHASSEE
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State | FL
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Zip | 32308-1550
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Country | US
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Telephone | 850-878-0184
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Fax | 850-216-1537
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY C DEEB
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Credential | M.D.
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Telephone | 850-878-0184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | ME0036405
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License Number State | FL
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