Provider Demographics
NPI:1780649996
Name:HORVATH, LARRY D (DO)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:D
Last Name:HORVATH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:503 PALM DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2660
Mailing Address - Country:US
Mailing Address - Phone:727-585-0308
Mailing Address - Fax:727-588-9598
Practice Address - Street 1:5880 49TH ST N
Practice Address - Street 2:SUITE 104
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2150
Practice Address - Country:US
Practice Address - Phone:727-528-6100
Practice Address - Fax:727-528-7895
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 4884207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064484600Medicaid
FL82874AMedicare PIN
FLP00412279Medicare PIN
FL6440380001Medicare NSC
FLE32309Medicare UPIN