Healthcare Provider Details

I. General information

NPI: 1407852254
Provider Name (Legal Business Name): LAWRENCE HURVITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 BEE RIDGE RD BLDG F
SARASOTA FL
34233-1207
US

IV. Provider business mailing address

3920 BEE RIDGE ROAD BUILDING F, SUITE B
SARASOTA FL
34233
US

V. Phone/Fax

Practice location:
  • Phone: 941-923-5491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberME35444
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: