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General NPI Number Information
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NPI Number | 1508051806
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Entity Type | Individual
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Provider Name | SANFORD LAWRENCE MARK D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 764 S TAMPA AVE UNIT D
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City | ORLANDO
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State | FL
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Zip | 32805-3600
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Country | US
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Telephone | 407-839-1700
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Fax | 407-839-1209
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Provider Business Mailing Address
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Address Line | 1417 LITCHEM RD
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City | APOPKA
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State | FL
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Zip | 32712-3068
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Country | US
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Telephone | 407-802-7731
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 9365
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License Number State | FL
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