Individual
DR. EDWIN R. LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2033 WOOD ST, STE 220, SARASOTA, FL 34237-7900
(941) 677-3366
(941) 677-3367
Mailing address
2033 WOOD ST, STE 220, SARASOTA, FL 34237-7900
(941) 677-3366
(941) 677-3367
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
35-04-1086
OH
2084P0800X
Psychiatry Physician
Primary
ME107312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0446063
MEDICARE P-CAN
OH
Enumeration date
09/05/2006
Last updated
01/08/2014
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