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General NPI Number Information
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NPI Number | 1851755383
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Entity Type | Organization
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Legal Business Name | LAWRENCE LOTTENBERG MD PA
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 3375 BURNS RD SUITE 206
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4349
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Country | US
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Telephone | 561-799-9559
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Fax | 561-799-9577
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Provider Business Mailing Address
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Address Line | 3375 BURNS RD SUITE 206
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4349
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Country | US
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Telephone | 561-799-9559
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Fax | 561-799-9577
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Authorized Official
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Title or Position | OWNER
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Name | LAWRENCE LOTTENBERG
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Credential | M.D.
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Telephone | 561-799-9559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | ME0027008
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License Number State | FL
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