Individual
KENNETH ANDREW LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
5511 S CONGRESS AVE, SUITE 105, ATLANTIS, FL 33462-1140
(561) 964-1635
(561) 964-1636
Mailing address
5511 S CONGRESS AVE, SUITE 105, ATLANTIS, FL 33462-1140
(561) 964-1635
(561) 964-1636
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME088693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270211800
—
FL
Enumeration date
10/16/2006
Last updated
02/11/2022
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