Provider Demographics
NPI:1487699690
Name:LARABEE, HEATHER STOCK (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:STOCK
Last Name:LARABEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5119 RIDGELAKE PL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-4442
Mailing Address - Country:US
Mailing Address - Phone:941-921-2382
Mailing Address - Fax:
Practice Address - Street 1:2179 S TAMIAMI TRAIL
Practice Address - Street 2:SUITE 101
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-9696
Practice Address - Country:US
Practice Address - Phone:941-966-0222
Practice Address - Fax:941-966-5100
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96018174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH61244Medicare UPIN