MEDICARE: LAWRENCE E. DORF 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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	ME0045095	FL

General Provider Information

NPI Number	:	1225123482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE E. DORF M.D.

Provider Business Mailing Address
First Line	:	4981 NW 102ND DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-1704
Country	:	US
Telephone Number	:	954-785-1640
Fax Number	:	954-752-0305

Provider Business Practice Location Address
First Line	:	4981 NW 102ND DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-1704
Country	:	US
Telephone Number	:	954-785-1640
Fax Number	:	954-752-0305

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	02/19/2013

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