Individual
DR. LARRY DOUGLAS VAN FOSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5955 RAND BLVD, SARASOTA, FL 34238-5160
(941) 893-6620
(941) 748-8440
Mailing address
5955 RAND BLVD, SARASOTA, FL 34238-5160
(941) 893-6620
(941) 748-8440
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS18532
FL
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
34.005429
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0981826
—
OH
05
—
114329900
—
FL
01
—
300135298
RR MEDICARE
OH
Enumeration date
07/25/2006
Last updated
03/28/2023
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