Organization
JUAN LARROUDE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN LARROUDE MD (OWNER)
(904) 797-2777
Entity
Organization
Contact information
Practice address
3100 US HIGHWAY 1 S, SUITE 1, ST AUGUSTINE, FL 32086-6351
(904) 824-4990
(904) 824-4990
Mailing address
3100 US HIGHWAY 1 S, SUITE 1, ST AUGUSTINE, FL 32086-6351
(904) 824-4990
(904) 824-4990
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA2597
RAILROAD MEDICARE
FL
Enumeration date
01/29/2007
Last updated
02/19/2008
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