Individual
LARRY S BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7125 MURRELL RD, MELBOURNE, FL 32940-7999
(321) 242-8790
(321) 751-9362
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5606
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME67730
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27194W
MEDICARE
FL
Enumeration date
09/07/2005
Last updated
06/25/2020
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