MEDICARE: SANDRA LAWRENCE MD PA

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	2080P0216X	Pediatric Rheumatology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538893722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDRA LAWRENCE MD PA

Provider Business Mailing Address
First Line	:	PO BOX 970845
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33497-0845
Country	:	US
Telephone Number	:	954-696-5623
Fax Number	:	561-756-8969

Provider Business Practice Location Address
First Line	:	9960 CENTRAL PARK BLVD N STE 225
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-1705
Country	:	US
Telephone Number	:	954-696-5623
Fax Number	:	561-756-8969

Authorized Official
Title or Position	:	OWNER
Name	:	SANDRA LAWRENCE
Credential	:	MD
Telephone Number	:	954-696-5623

Provider Enumeration Date	:	07/13/2022
Last Update Date	:	07/13/2022

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