Provider Demographics
NPI:1679822886
Name:LARKIN, KATHRYN ANNE (OD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNE
Last Name:LARKIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 SW 145TH TER STE 3050
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1444
Mailing Address - Country:US
Mailing Address - Phone:954-392-4111
Mailing Address - Fax:954-392-4113
Practice Address - Street 1:323 SW 145TH TER STE 3050
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1444
Practice Address - Country:US
Practice Address - Phone:954-392-4111
Practice Address - Fax:954-392-4113
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4737152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist