MEDICARE: CORY DWAYNE LAMAR 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	2084E0001X	Epilepsy Physician	ME142606	FL
2	2084N0400X	Neurology Physician	ME142606	FL
3	2084N0400X	Neurology Physician	20342	NH
4	2084N0400X	Neurology Physician	91191	MT
5	2084N0400X	Neurology Physician	84889	GA
6	2084N0400X	Neurology Physician	2011-01207	NC
7	208M00000X	Hospitalist Physician	84889	GA
8	390200000X	Student in an Organized Health Care Education/Training Program
9	2084E0001X	Epilepsy Physician	ME142626	FL

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	:	1740469030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORY DWAYNE LAMAR M.D.

Provider Business Mailing Address
First Line	:	9960 NW 116TH WAY STE 13
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33178-1175
Country	:	US
Telephone Number	:	786-924-1311
Fax Number	:	786-924-1313

Provider Business Practice Location Address
First Line	:	800 GOODLETTE-FRANK RD N STE 205
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-5408
Country	:	US
Telephone Number	:	239-667-5878
Fax Number	:	238-667-5838

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

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	08/04/2025

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