Basic Information
| Provider Information | |||||||||
| NPI: | 1558461319 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAROCHE | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | JPE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CRT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 287 SW FEDORA WAY | ||||||||
| Address2: | |||||||||
| City: | LAKE CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320252129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867521786 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 609 SOUTH MARION ST. | ||||||||
| Address2: | |||||||||
| City: | LAKE CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867553016 | ||||||||
| FaxNumber: | 3867586014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2278G1100X | TT461 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care |
No ID Information.