Provider Demographics
NPI:1902873532
Name:MENESTRINA, LARRY EUGENE (DO)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:EUGENE
Last Name:MENESTRINA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3704
Mailing Address - Country:US
Mailing Address - Phone:561-832-2803
Mailing Address - Fax:561-832-2810
Practice Address - Street 1:228 9TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3704
Practice Address - Country:US
Practice Address - Phone:561-832-2803
Practice Address - Fax:561-832-2810
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20CA 57802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF18300Medicare UPIN
AZ954MMedicare UPIN