| Larry D Canton Do Pa | |
|
2888 Roosevelt Blvd Clearwater FL 33760-1923 | |
| (727) 524-7988 | |
| (727) 524-4942 |
| Full Name | Larry D Canton Do Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 2888 Roosevelt Blvd, Clearwater, Florida |
| Authorized Official Name and Position | Larry D Canton (OWNER) |
| Authorized Official Contact | 7275247988 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry D Canton Do Pa 2888 Roosevelt Blvd Clearwater FL 33760-1923 Ph: (727) 524-7988 | Larry D Canton Do Pa 2888 Roosevelt Blvd Clearwater FL 33760-1923 Ph: (727) 524-7988 |
| NPI Number | 1073795274 |
|---|---|
| Provider Enumeration Date | 11/29/2007 |
| Last Update Date | 02/29/2008 |
| Medicare PECOS PAC ID | 5799860680 |
|---|---|
| Medicare Enrollment ID | O20080318000124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073795274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS4904 (Florida) | Primary |
| Provider Name | Larry D Canton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942277629 PECOS PAC ID: 8426089475 Enrollment ID: I20050830000094 |
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