Individual
PAUL E LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 BRENT LN, PENSACOLA, FL 32503-2003
(850) 471-2221
(850) 471-2232
Mailing address
PO BOX 18868, PENSACOLA, FL 32523-8868
(850) 994-5660
(850) 994-5841
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME 40352
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067040500
—
FL
01
—
160055559
RAILROAD MEDICARE
FL
01
—
17523
BLUE CROSS BLUE SHIELD FL
FL
01
—
434705599
TRICARE
FL
01
—
59167048
BLUE CROSS BLUE SHIELD AL
AL
01
—
Z113
VISTA
FL
Enumeration date
01/18/2006
Last updated
02/03/2010
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