MEDICARE: DR. LAWRENCE G OLIVER MD

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	207RC0000X	Cardiovascular Disease Physician	ME 57917	FL

General Provider Information

NPI Number	:	1295787794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE G OLIVER MD

Provider Business Mailing Address
First Line	:	1900 NEBRASKA AVE
Second Line	:	SUITE 9
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4837
Country	:	US
Telephone Number	:	772-465-4499
Fax Number	:	772-465-5941

Provider Business Practice Location Address
First Line	:	1900 NEBRASKA AVE
Second Line	:	SUITE 9
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4837
Country	:	US
Telephone Number	:	772-465-4499
Fax Number	:	772-465-5941

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	01/11/2026

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