MEDICARE: LAWRENCE CARECONCEPT, INC.

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	251E00000X	Home Health Agency	000224200	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000224200	OTHER	FL	MED WAVIER PROVIVER

General Provider Information

NPI Number	:	1164725925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE CARECONCEPT, INC.

Provider Business Mailing Address
First Line	:	21205 NW 14TH PL APT 219
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-7445
Country	:	US
Telephone Number	:	305-651-7488
Fax Number	:	305-651-7488

Provider Business Practice Location Address
First Line	:	21205 NW 14TH PL APT 219
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-7445
Country	:	US
Telephone Number	:	305-651-7488
Fax Number	:	305-651-7488

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. AUDREY C LAWRENCE
Credential	:
Telephone Number	:	305-651-7488

Provider Enumeration Date	:	12/15/2010
Last Update Date	:	12/15/2010

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Directions to “LAWRENCE CARECONCEPT, INC. ” Practice Location

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