Individual
JACOB LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RD
Contact information
Practice address
13800 VETERANS WAY, ORLANDO, FL 32827-7401
(407) 757-7484
Mailing address
13800 VETERANS WAY, ORLANDO, FL 32827-7401
(407) 757-7484
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
FL
Other
Enumeration date
12/28/2023
Last updated
04/21/2025
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