Provider Demographics
NPI:1235441007
Name:EARL I. LA KIER, MD, PA
Entity Type:Organization
Organization Name:EARL I. LA KIER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:ISAAC
Authorized Official - Last Name:LA KIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-746-7515
Mailing Address - Street 1:2151 S ALTERNATE A1A
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-4112
Mailing Address - Country:US
Mailing Address - Phone:561-746-7515
Mailing Address - Fax:561-746-7875
Practice Address - Street 1:2151 S ALTERNATE A1A
Practice Address - Street 2:SUITE 1250
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-4112
Practice Address - Country:US
Practice Address - Phone:561-746-7515
Practice Address - Fax:561-746-7875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG59710Medicare UPIN