Provider Demographics
NPI:1407838519
Name:KOHN, LAWRENCE L (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:L
Last Name:KOHN
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 1:1845 VETERANS PARK DR STE 110
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0493
Mailing Address - Country:US
Mailing Address - Phone:239-624-0470
Mailing Address - Fax:239-624-0471
Practice Address - Street 1:1845 VETERANS PARK DR STE 110
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0493
Practice Address - Country:US
Practice Address - Phone:239-624-0470
Practice Address - Fax:239-624-0471
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116112207R00000X
NY157668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011145600Medicaid
FL14U2YOtherBCBS
FLHT485ZOtherMEDICARE
FL14U2YOtherBCBS
NY008291307Medicaid
FL14U2YOtherBCBS
NY39442BMedicare ID - Type Unspecified