Provider Demographics
NPI:1891774865
Name:FELDMAN, LAWRENCE E (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:E
Last Name:FELDMAN
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 1:48 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139
Mailing Address - Country:US
Mailing Address - Phone:305-608-9544
Mailing Address - Fax:786-359-4700
Practice Address - Street 1:48 PALM AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139
Practice Address - Country:US
Practice Address - Phone:305-665-0585
Practice Address - Fax:305-662-1359
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL47975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D64955Medicare UPIN
FL96953Medicare ID - Type Unspecified