MEDICARE: DR. LAWRENCE MICHAEL FIEDLER 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	207RG0100X	Gastroenterology Physician	ME 80130	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932135803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE MICHAEL FIEDLER M.D.

Provider Business Mailing Address
First Line	:	5431 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4639
Country	:	US
Telephone Number	:	954-344-2522
Fax Number	:	954-344-9189

Provider Business Practice Location Address
First Line	:	2300 GLADES RD
Second Line	:	SUITE 201E
City	:	BOCA RATON
State	:	FL
Zip	:	33431-7386
Country	:	US
Telephone Number	:	561-208-2121
Fax Number	:	561-393-1729

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	10/10/2012

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