Provider Demographics
NPI:1235110164
Name:LARROY, KAREN LIZ (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LIZ
Last Name:LARROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S5-12 CALLE CATARATAS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6126
Mailing Address - Country:US
Mailing Address - Phone:787-632-3516
Mailing Address - Fax:
Practice Address - Street 1:S5-12 CALLE CATARATAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6126
Practice Address - Country:US
Practice Address - Phone:787-632-3516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14830207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14830OtherLIC
PR116450Medicare UPIN
PR22455Medicare ID - Type Unspecified