Provider Demographics
NPI:1619483799
Name:LARSON, PAUL SETH (ARNP-FNP)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:SETH
Last Name:LARSON
Suffix:
Gender:M
Credentials:ARNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 BAYSHORE BLVD UNIT D21
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8859
Mailing Address - Country:US
Mailing Address - Phone:813-352-1354
Mailing Address - Fax:
Practice Address - Street 1:6919 N DALE MABRY HWY STE 125
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3972
Practice Address - Country:US
Practice Address - Phone:813-497-9661
Practice Address - Fax:813-615-8468
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9352380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily