Healthcare Provider Details

I. General information

NPI: 1659288652
Provider Name (Legal Business Name): ANDREA LAWRENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3211 FERNWOOD DR
BOYNTON BEACH FL
33435-8124
US

IV. Provider business mailing address

3211 FERNWOOD DR
BOYNTON BEACH FL
33435-8124
US

V. Phone/Fax

Practice location:
  • Phone: 954-263-0088
  • Fax:
Mailing address:
  • Phone: 954-263-0088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHOOO6434
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: