Provider Demographics
NPI:1659474260
Name:LARNED, CATHERINE C (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:C
Last Name:LARNED
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:PO BOX 281
Mailing Address - Street 2:4707 PINE ISLAND RD
Mailing Address - City:MATLACHA
Mailing Address - State:FL
Mailing Address - Zip Code:33993-0281
Mailing Address - Country:US
Mailing Address - Phone:239-283-0784
Mailing Address - Fax:239-283-0735
Practice Address - Street 1:4707 PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:MATLACHA
Practice Address - State:FL
Practice Address - Zip Code:33993-0281
Practice Address - Country:US
Practice Address - Phone:239-283-0784
Practice Address - Fax:239-283-0735
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME711532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256882900Medicaid
FL32250OtherBCBS
B74473Medicare UPIN
FL32250ZMedicare ID - Type Unspecified