Provider Demographics
NPI:1669795076
Name:LARRAIN, FLORENCE Q (PSYCHOLOGIST)
Entity type:Individual
Prefix:PROF
First Name:FLORENCE
Middle Name:Q
Last Name:LARRAIN
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2060
Mailing Address - Country:US
Mailing Address - Phone:305-442-8833
Mailing Address - Fax:305-463-6693
Practice Address - Street 1:717 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 318
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2060
Practice Address - Country:US
Practice Address - Phone:305-442-8833
Practice Address - Fax:305-463-6693
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6882103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist