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Individual

LARRY J. DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
701 6TH ST S, ST PETERSBURG, FL 33701-4814
(727) 893-6182
(727) 893-6861
Mailing address
PO BOX 402643, ATLANTA, GA 30384-2643
(727) 893-6182

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME0024195
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
067949600
FL
Enumeration date
07/18/2006
Last updated
09/01/2010
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