Provider Demographics
NPI:1013172295
Name:LARRY QUIRIT, M.D., P.A.
Entity type:Organization
Organization Name:LARRY QUIRIT, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:FENOL
Authorized Official - Last Name:QUIRIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-398-0043
Mailing Address - Street 1:1810 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5545
Mailing Address - Country:US
Mailing Address - Phone:772-398-0043
Mailing Address - Fax:772-398-4914
Practice Address - Street 1:1810 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5545
Practice Address - Country:US
Practice Address - Phone:772-398-0043
Practice Address - Fax:772-398-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47876207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty