Larry Albert Antolick, D.O.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

OS8066 Issued in FL

Practice address

3527 Somerset Cir
Kissimmee, FL 34746-2874

Phone

(407) 518-0420

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073654422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 SOMERSET CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462874",
            "telephone_number": "407-518-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 SOMERSET CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462874",
            "telephone_number": "407-518-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOLICK",
        "first_name": "LARRY",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "OS003289L",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "OS8066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amer Ansari, DO
• Mohammed Saifuddin Ansari
• Cedrick E Anson, MD
• Kayla Brianna Antequera
• Natasha Anthony
• Antonio Steadman LLC
• Anjitha Susan Anu, PHARM D
• Mohammad Badar Anwer, MD
• Jesmarie Anza Torres, SLP
• Aod Dental Clinic, Inc.

• Geriatric Medicine (Family Medicine) Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Geriatric Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.