Organization
LARRY D MASTROGIANAKIS, MD PEDIATRIC AND ADOLESCENT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D MASTROGIANAKIS MD (OWNER)
(904) 429-9989
Entity
Organization
Contact information
Practice address
101 E TOWN PL STE 215, ST AUGUSTINE, FL 32092-2821
(904) 429-9989
Mailing address
101 E TOWN PL STE 215, ST AUGUSTINE, FL 32092-2821
(904) 429-9989
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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