Healthcare Provider Details

I. General information

NPI: 1821217811
Provider Name (Legal Business Name): LF MD PA DBA LAWRENCE FELDMAN MD ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 17TH ST STE 400
MIAMI BEACH FL
33139-1854
US

IV. Provider business mailing address

777 17TH ST STE 400
MIAMI BEACH FL
33139-1854
US

V. Phone/Fax

Practice location:
  • Phone: 305-673-3555
  • Fax:
Mailing address:
  • Phone: 305-673-3555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME0047975
License Number StateFL

VIII. Authorized Official

Name: LAWRENCE E FELDMAN
Title or Position: DIRECTOR
Credential: M.D
Phone: 305-673-3555