Larry S Bishop, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME67730 Issued in FL

Practice address

7125 Murrell Rd
Melbourne, FL 32940-7999

Phone

(321) 242-8790

Fax

(321) 751-9362

NPI assigned

Sep 7, 2005

Last updated

Jun 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1255325049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-361-5606",
            "fax_number": "321-951-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 MURRELL RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407999",
            "telephone_number": "321-242-8790",
            "fax_number": "321-751-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "LARRY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME67730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "27194W",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Jason Biondi, D.C., P.A.
• Denton Birch
• Alison Rachel Bird, APRN, CPNP
• Anthony Nicholas Biscardi
• Christina Nguyen Bischof, M.D.
• Rachael Renee Bishop, APRN
• Dylan Isaiah Bissessarsingh
• Dominyka Bitinaite, MD
• Theresa Marie Black, APRN
• Abigail Blackman

• Dermatology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.