MEDICARE: MR. LAWRENCE MEINER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	004301	NY
2	363AS0400X	Surgical Physician Assistant	9111483	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457589921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAWRENCE MEINER PA-C

Provider Business Mailing Address
First Line	:	8404 GRAND MESSINA CIR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-7104
Country	:	US
Telephone Number	:	917-567-2896
Fax Number	:

Provider Business Practice Location Address
First Line	:	8404 GRAND MESSINA CIR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-7104
Country	:	US
Telephone Number	:	917-567-2896
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	05/06/2021

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