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Contact Information

LARRY D VAN FOSSEN, DO
5955 RAND BLVD
SARASOTA, FL34238-5160
 Phone: 941-893-6620
 Fax: 941-748-8440
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Hospice and Palliative Medicine

207LH0002X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for LARRY D VAN FOSSEN · (Male)

NPI # 1497778054
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/25/2006
Last updated 03/28/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # OS18532
  • OH License # 34.005429
  • FL Medicaid 114329900
  • OH Medicaid 0981826
  • OH Other 300135298 RR MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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