Organization
LARGEN & CLONTZ SURGICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN E NUTTER (INSURANCE COOR)
(407) 322-7841
Entity
Organization
Contact information
Practice address
819 E 1ST ST, SANFORD, FL 32771
(407) 322-7841
(407) 322-1778
Mailing address
819 E 1ST ST, SANFORD, FL 32771
(407) 322-7841
(407) 322-1778
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045563600
—
FL
Enumeration date
11/27/2006
Last updated
07/09/2008
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