Provider Demographics
NPI:1942476551
Name:LAURENCE, RASHIDA A (MD)
Entity Type:Individual
Prefix:
First Name:RASHIDA
Middle Name:A
Last Name:LAURENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RASHIDA
Other - Middle Name:A
Other - Last Name:JEFFERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3601 SW 160TH AVE
Mailing Address - Street 2:SUITE #250
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6308
Mailing Address - Country:US
Mailing Address - Phone:305-866-9951
Mailing Address - Fax:877-284-8933
Practice Address - Street 1:3601 SW 160TH AVE
Practice Address - Street 2:SUITE #250
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-6308
Practice Address - Country:US
Practice Address - Phone:306-866-9951
Practice Address - Fax:877-284-8933
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-03
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068408207Q00000X
DCMD037627207Q00000X
PAMD443514208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine