Provider Demographics
NPI:1063476653
Name:SCHACHNER, LAWRENCE A (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:SCHACHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 NW 12 AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101-6960
Mailing Address - Country:US
Mailing Address - Phone:305-243-7688
Mailing Address - Fax:305-243-6191
Practice Address - Street 1:1475 NW 12 AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33101-6960
Practice Address - Country:US
Practice Address - Phone:305-243-7688
Practice Address - Fax:305-243-6191
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31907207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0371025-00Medicaid
FL0371025-00Medicaid
FL92981Medicare ID - Type Unspecified