Provider Demographics
NPI:1528394871
Name:LARODAT INTEGRATED HEALTH SERVICES
Entity Type:Organization
Organization Name:LARODAT INTEGRATED HEALTH SERVICES
Other - Org Name:ORANGEBAY SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NEW OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:MORFFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-443-4536
Mailing Address - Street 1:1450 SKIPPER RD
Mailing Address - Street 2:SUITE 32
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-2372
Mailing Address - Country:US
Mailing Address - Phone:813-443-4536
Mailing Address - Fax:813-443-4880
Practice Address - Street 1:1450 SKIPPER RD
Practice Address - Street 2:SUITE 32
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2372
Practice Address - Country:US
Practice Address - Phone:813-443-4536
Practice Address - Fax:813-443-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
FLPH242313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123022OtherPK