Organization
LARRY R BACHLE DO FACOEP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY R BACHLE DO FACOEP (PHYSICIAN)
(941) 764-9560
Entity
Organization
Contact information
Practice address
25097 OLYMPIA AVE, SUITE 107, PUNTA GORDA, FL 33950-3903
(941) 205-2620
(941) 205-2630
Mailing address
PO BOX 510669, PUNTA GORDA, FL 33951-0669
(941) 764-9560
(941) 205-2630
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
OS6291
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37095230
—
FL
01
—
DE7887
RR MEDICARE GRP #
FL
01
—
P00316034
RR MEDICARE
FL
Enumeration date
05/12/2006
Last updated
04/15/2013
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