Provider Demographics
NPI:1043449960
Name:LAWSON, MICHAEL JAMES (ARNP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:LAWSON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9779 TREASURE CAY LN
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-6808
Mailing Address - Country:US
Mailing Address - Phone:239-949-2917
Mailing Address - Fax:239-949-2917
Practice Address - Street 1:2525 HARBOR BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5317
Practice Address - Country:US
Practice Address - Phone:941-629-9190
Practice Address - Fax:941-625-2751
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA30334225700000X
FLARNP9250725363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist