Healthcare Provider Details

I. General information

NPI: 1679540744
Provider Name (Legal Business Name): LAURENCE R FERBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 01/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7062 S ALOYSIA AVE
FLORAL CITY FL
34436-2844
US

IV. Provider business mailing address

403 W HIGHLAND BLVD
INVERNESS FL
34452-4717
US

V. Phone/Fax

Practice location:
  • Phone: 352-364-4038
  • Fax: 352-419-4302
Mailing address:
  • Phone: 352-726-3646
  • Fax: 352-726-0079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberME85110
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME85110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: