Healthcare Provider Details

I. General information

NPI: 1215699152
Provider Name (Legal Business Name): MR. STEVEN LAWSON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 NW 119TH ST APT 223
NORTH MIAMI FL
33167-2754
US

IV. Provider business mailing address

1810 NW 119TH ST APT 223
NORTH MIAMI FL
33167-2754
US

V. Phone/Fax

Practice location:
  • Phone: 305-206-3566
  • Fax:
Mailing address:
  • Phone: 305-206-3566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR066678
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH15913
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL6783
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT004374
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: