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NPI Code Detail

MEDICARE: LARRY A LATSON MD

MEDICARE: LARRY A LATSON MD
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
12080P0202XPediatric Cardiology PhysicianME109333FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366538027
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARRY A LATSON MD
Provider Business Mailing Address
First Line : 2900 CORPORATE WAY
Second Line : DOOR D
City : MIRAMAR
State : FL
Zip : 33025-3925
Country : US
Telephone Number : 954-276-5685
Fax Number : 954-985-7074
Provider Business Practice Location Address
First Line : 1150 N 35TH AVE STE 490
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-5423
Country : US
Telephone Number : 954-265-3437
Fax Number : 954-265-3731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 04/23/2021

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Directions to “ LARRY A LATSON MD” Practice Location

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