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General NPI Number Information
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NPI Number | 1013281278
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Entity Type | Organization
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Legal Business Name | LAWRENCE MADIEFSKY,DPM,PA
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 8110 ROYAL PALM BLVD SUITE 110
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5795
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Country | US
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Telephone | 954-341-8513
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Fax | 954-341-8514
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Provider Business Mailing Address
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Address Line | 9750 NW 33RD STREET SUITE 201
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-0000
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Country | US
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Telephone | 954-341-8513
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Fax | 954-341-8514
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE MADIEFSKY
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Credential | DPM
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Telephone | 954-341-8513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | 1602
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License Number State | FL
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