Healthcare Provider Details

I. General information

NPI: 1942266366
Provider Name (Legal Business Name): LAWRENCE S AMESSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12955 PALMS WEST DR STE 200
LOXAHATCHEE FL
33470-9217
US

IV. Provider business mailing address

7837 VENTURE CENTER WAY SUITE 5105
BOYNTON BEACH FL
33437-7414
US

V. Phone/Fax

Practice location:
  • Phone: 561-527-0816
  • Fax: 561-257-0817
Mailing address:
  • Phone: 937-545-2011
  • Fax: 561-257-0817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberME 116927
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: