Healthcare Provider Details
I. General information
NPI: 1629852744
Provider Name (Legal Business Name): LS MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3129 ALTERNATE 19
DUNEDIN FL
34698-1503
US
IV. Provider business mailing address
3129 ALTERNATE 19
DUNEDIN FL
34698-1503
US
V. Phone/Fax
- Phone: 727-400-4768
- Fax: 727-265-3420
- Phone: 727-400-4768
- Fax: 727-265-3420
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2082S0105X |
| Taxonomy | Surgery of the Hand (Plastic Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
EREL
LAUFER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-400-4768