Provider Demographics
NPI:1942266366
Name:AMESSE, LAWRENCE S (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:S
Last Name:AMESSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7837 VENTURE CENTER WAY
Mailing Address - Street 2:SUITE 5105
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-7414
Mailing Address - Country:US
Mailing Address - Phone:937-545-2011
Mailing Address - Fax:561-257-0817
Practice Address - Street 1:12955 PALMS WEST DR STE 200
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9217
Practice Address - Country:US
Practice Address - Phone:561-527-0816
Practice Address - Fax:561-257-0817
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2022-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 116927207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2071877Medicaid
0867491Medicare PIN
G29497Medicare UPIN