Provider Demographics
NPI:1326456674
Name:SOFER, LAUREL ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:ANNE
Last Name:SOFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:ANNE
Other - Last Name:GRABAWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,
Mailing Address - Street 1:3700N LAKE SHORE DR 124
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4200
Mailing Address - Country:US
Mailing Address - Phone:914-907-5158
Mailing Address - Fax:
Practice Address - Street 1:5850 CORAL RIDGE DR STE 106
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3379
Practice Address - Country:US
Practice Address - Phone:954-714-8200
Practice Address - Fax:954-840-2626
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME143182208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty