MEDICARE: LAWRENCE P. BRUNO, M.D., 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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1720484009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE P. BRUNO, M.D., INC.

Provider Business Mailing Address
First Line	:	19250 BAGLEY RD
Second Line	:	SUITE 105
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3347
Country	:	US
Telephone Number	:	440-826-0770
Fax Number	:

Provider Business Practice Location Address
First Line	:	19250 BAGLEY RD
Second Line	:	SUITE 105
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3347
Country	:	US
Telephone Number	:	440-826-0770
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/PRESIDENT
Name	:	LAWRENCE PAUL BRUNO
Credential	:	M.D.
Telephone Number	:	440-826-0770

Provider Enumeration Date	:	11/13/2014
Last Update Date	:	01/07/2015

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