Provider Demographics
NPI:1588608624
Name:LAQUIS, STEPHEN J (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:J
Last Name:LAQUIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7331 COLLEGE PKWY
Mailing Address - Street 2:STE 200
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5524
Mailing Address - Country:US
Mailing Address - Phone:239-947-4042
Mailing Address - Fax:239-390-9976
Practice Address - Street 1:7331 COLLEGE PKWY
Practice Address - Street 2:STE 200
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5524
Practice Address - Country:US
Practice Address - Phone:239-947-4042
Practice Address - Fax:239-390-9976
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2014-11-03
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Provider Licenses
StateLicense IDTaxonomies
FLME82974207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28077Medicare PIN
FLH10745Medicare UPIN
180045484Medicare PIN
H10745Medicare UPIN