Individual
LARRY M BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5401 S CONGRESS AVE STE 201, ATLANTIS, FL 33462-6637
(561) 967-0101
(561) 967-6260
Mailing address
5401 S CONGRESS AVE STE 201, ATLANTIS, FL 33462-6637
(561) 967-0101
(561) 967-6260
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME0055230
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036606400
—
FL
Enumeration date
11/21/2005
Last updated
02/18/2022
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