Provider Demographics
NPI:1578522181
Name:MAIR, LAURENCE SIMON (DC)
Entity Type:Individual
Prefix:
First Name:LAURENCE
Middle Name:SIMON
Last Name:MAIR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 SW 62ND AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4716
Mailing Address - Country:US
Mailing Address - Phone:305-271-1652
Mailing Address - Fax:305-271-1855
Practice Address - Street 1:7000 SW 62ND AVE STE 201
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4716
Practice Address - Country:US
Practice Address - Phone:305-271-1652
Practice Address - Fax:305-271-1855
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor