Provider Demographics
NPI:1033930607
Name:LARSH, BIANCA MICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:MICHELLE
Last Name:LARSH
Suffix:
Gender:
Credentials:PA-C
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Mailing Address - Street 1:16512 LAKE HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1165
Mailing Address - Country:US
Mailing Address - Phone:786-417-9542
Mailing Address - Fax:
Practice Address - Street 1:2501 N ORANGE AVE STE 381
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4623
Practice Address - Country:US
Practice Address - Phone:407-609-9076
Practice Address - Fax:407-609-9077
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2025-03-27
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant