Provider Demographics
NPI:1952597619
Name:BISCHOF, LARRY J (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:J
Last Name:BISCHOF
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 W. DR. MARTIN LUTHER KING JR, BLVD
Mailing Address - Street 2:ST. JOSEPH'S HOSPITAL, DEPARTMENT OF PATHOLOGY
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607
Mailing Address - Country:US
Mailing Address - Phone:813-357-1671
Mailing Address - Fax:
Practice Address - Street 1:3001 W. DR. MARTIN LUTHER KING JR, BLVD
Practice Address - Street 2:ST. JOSEPH'S HOSPITAL, DEPARTMENT OF PATHOLOGY
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-357-1671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 109929207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine