Wilhelm C.J. Larsen, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME27507 Issued in FL

Practice address

10301 Hagen Ranch Road
Suite B6
Boynton Beach, FL 33437-3723

Phone

(561) 752-9490

Fax

(561) 752-9491

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1295773166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 NE 125TH STREET",
            "address_2": "SUITE 409",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615834",
            "telephone_number": "888-852-6672",
            "fax_number": "305-891-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 HAGEN RANCH ROAD",
            "address_2": "SUITE B6",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373723",
            "telephone_number": "561-752-9490",
            "fax_number": "561-752-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "WILHELM",
        "middle_name": "C.J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME27507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274949100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Language of Learning STC, LLC
• Alexander David Lantz, PTA
• Melaine Lanza, M.D
• Sylvie Star Lanza, APRN
• Panupong Larppanichpoonphol, MD
• Kelly Larue
• Steven Alan Lashley, D.P.M.
• Lori Lashomb, PT
• David Lashway, MD
• Justine Marie Latif, PHARMD, BCACP

• Internal Medicine Physician in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.