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Individual

LARRY CHARLES DEEB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2633 CENTENNIAL BLVD STE 100, TALLAHASSEE, FL 32308-0606
(850) 431-5404
Mailing address
2633 CENTENNIAL BLVD, SUITE 100, TALLAHASSEE, FL 32309-0585
(850) 877-7387
(850) 656-3376

Taxonomy

Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
ME 36405
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00241018C
GA
05
039439400
FL
01
37276
BLUECROSS BLUE SHIELD
FL
Enumeration date
09/21/2005
Last updated
04/13/2020
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