MEDICARE: LARRY DAVID FLORMAN 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
1	2086S0122X	Plastic and Reconstructive Surgery Physician	17061	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	50000375	OTHER	KY	PASSPORT

General Provider Information

NPI Number	:	1639158272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY DAVID FLORMAN MD

Provider Business Mailing Address
First Line	:	401 E CHESTNUT ST
Second Line	:	SUITE 710
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-5700
Country	:	US
Telephone Number	:	502-583-8303
Fax Number	:	502-584-0302

Provider Business Practice Location Address
First Line	:	401 E CHESTNUT ST
Second Line	:	SUITE 710
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-5700
Country	:	US
Telephone Number	:	502-583-8303
Fax Number	:	502-584-0302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	07/30/2009

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