Provider Demographics
NPI:1316136948
Name:CATHERINE LARNED MD & ASSOCIATES PA
Entity type:Organization
Organization Name:CATHERINE LARNED MD & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LARNED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-283-0784
Mailing Address - Street 1:4707 PINE ISLAND RD NW
Mailing Address - Street 2:
Mailing Address - City:MATLACHA
Mailing Address - State:FL
Mailing Address - Zip Code:33993-0281
Mailing Address - Country:US
Mailing Address - Phone:239-283-0784
Mailing Address - Fax:239-283-0735
Practice Address - Street 1:4707 PINE ISLAND RD NW
Practice Address - Street 2:
Practice Address - City:MATLACHA
Practice Address - State:FL
Practice Address - Zip Code:33993-9710
Practice Address - Country:US
Practice Address - Phone:239-283-0784
Practice Address - Fax:239-283-0735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071153261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8909Medicare PIN