Provider Demographics
NPI:1003031584
Name:LEHMAN, LAUREL ELIZABETH (PA)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:ELIZABETH
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:ELIZABETH
Other - Last Name:KOVACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:954-741-4280
Mailing Address - Fax:954-741-4912
Practice Address - Street 1:4279 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6044
Practice Address - Country:US
Practice Address - Phone:954-741-4280
Practice Address - Fax:954-741-4912
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104054363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9104054OtherLICENSE
FL292740300Medicaid