MEDICARE: ANGELA LAWRENCE

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	174400000X	Specialist	AL2025	FL

General Provider Information

NPI Number	:	1497142590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA LAWRENCE

Provider Business Mailing Address
First Line	:	2135 EOLA CT
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-8028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4180 N ORION BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32816-8029
Country	:	US
Telephone Number	:	407-823-4955
Fax Number	:

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

Provider Enumeration Date	:	04/16/2015
Last Update Date	:	04/16/2015

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Directions to “ ANGELA LAWRENCE ” Practice Location

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