Individual
LARRY E MAYOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
8151 ULMERTON RD, LARGO, FL 33771-3959
(727) 539-6764
(727) 530-0125
Mailing address
8193 PERTH DR, LARGO, FL 33773-2942
(727) 430-4724
(727) 530-0125
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
AL200
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL200
FLORIDA ATHLETIC TRAINER
FL
Enumeration date
05/22/2007
Last updated
07/08/2007
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