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NPI Code Detail

MEDICARE: LARITSSA PALACIO COBIAN MD

MEDICARE: LARITSSA PALACIO COBIAN 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
12080A0000XPediatric Adolescent Medicine PhysicianME85208FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
157651OTHERFLBCBS FILING NUMBER

General Provider Information

NPI Number : 1578639894
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARITSSA PALACIO COBIAN MD
Provider Business Mailing Address
First Line : 8701 MAITLAND SUMMIT BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32810-5915
Country : US
Telephone Number : 407-916-4522
Fax Number : 407-916-4525
Provider Business Practice Location Address
First Line : 8701 MAITLAND SUMMIT BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32810-5915
Country : US
Telephone Number : 407-916-4522
Fax Number : 407-916-4525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 07/08/2007

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Directions to “ LARITSSA PALACIO COBIAN MD” Practice Location

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