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General NPI Number Information
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NPI Number | 1750968152
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Entity Type | Individual
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Provider Name | LAWRENCE BRUNDIDGE II MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 8201 W BROWARD BLVD
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City | PLANTATION
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State | FL
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Zip | 33324-2701
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Country | US
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Telephone | 954-473-6600
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Fax | 727-819-2928
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Provider Business Mailing Address
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Address Line | 601 E ALTAMONTE DR
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4802
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Country | US
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Telephone | 407-303-2200
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME170207
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License Number State | FL
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