Provider Demographics
NPI:1154493591
Name:LAFFER, SAMUEL (AP)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:LAFFER
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 SE 4TH AVE
Mailing Address - Street 2:APT 303
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-3144
Mailing Address - Country:US
Mailing Address - Phone:954-523-8840
Mailing Address - Fax:
Practice Address - Street 1:2337 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-5842
Practice Address - Country:US
Practice Address - Phone:954-423-9234
Practice Address - Fax:954-423-9231
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1934171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP1934OtherFL LIC NUMBER