MEDICARE: DR. LAWRENCE STEPHEN BURNS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	ME47247	FL

General Provider Information

NPI Number	:	1003812363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE STEPHEN BURNS M.D.

Provider Business Mailing Address
First Line	:	2255 SW 145TH AVE
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33325-4901
Country	:	US
Telephone Number	:	954-290-3726
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 N 35TH AVE
Second Line	:	SUITE 205
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5424
Country	:	US
Telephone Number	:	954-583-7770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	10/18/2007

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