Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO 1356 | FL |
NPI | 1407853831 |
---|---|
Provider Name | Dr. Larry A. Aronberg |
First Address | Lake Worth, FL 33460-3837 |
Second Address | Lake Worth, FL 33460-3837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 01/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
87735X | MEDICARE (01) | FL |
T55523 | (02) | FL |