Individual
MR. LARRY J. AMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8480 SW 140TH ST, PALMETTO BAY, FL 33158-1040
(305) 298-1355
(786) 242-3598
Mailing address
8480 SW 140TH ST, PALMETTO BAY, FL 33158-1040
(305) 298-1355
(786) 242-3598
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
CBC1256251
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171WH0202X
TAXONOMY CODES
FL
Enumeration date
08/09/2012
Last updated
08/09/2012
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