Provider Demographics
NPI:1982823209
Name:AUDINO, LAWRENCE F (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:F
Last Name:AUDINO
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 1:284 SEA MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-3926
Mailing Address - Country:US
Mailing Address - Phone:401-293-0933
Mailing Address - Fax:
Practice Address - Street 1:284 SEA MEADOW DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-3926
Practice Address - Country:US
Practice Address - Phone:401-293-0933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA33954208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology