Provider Demographics
NPI:1437272002
Name:HOLFELDER, LAWRENCE ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ANDREW
Last Name:HOLFELDER
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 1:11730 LIPSEY RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3620
Mailing Address - Country:US
Mailing Address - Phone:813-961-0790
Mailing Address - Fax:
Practice Address - Street 1:13101 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3803
Practice Address - Country:US
Practice Address - Phone:813-396-9748
Practice Address - Fax:813-396-9750
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15136251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health