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Individual

DR. LARRY MATSUMOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1888 HILLVIEW ST, SARASOTA, FL 34239-3605
(941) 917-6260
(941) 917-6266
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884

Taxonomy

Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
055424
GA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME138959
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
186509177A
GA
05
186509177B
GA
05
186509177D
GA
05
186509177E
GA
05
186509177G
GA
Enumeration date
08/08/2006
Last updated
01/15/2019
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