Provider Demographics
NPI:1255621538
Name:LAWRENCE D. LAMPERT OD, PA
Entity type:Organization
Organization Name:LAWRENCE D. LAMPERT OD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIELZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-482-1144
Mailing Address - Street 1:7035 BERACASA WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3454
Mailing Address - Country:US
Mailing Address - Phone:561-391-3334
Mailing Address - Fax:
Practice Address - Street 1:9858 CLINT MOORE RD
Practice Address - Street 2:SUITE C111-274
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-1034
Practice Address - Country:US
Practice Address - Phone:561-482-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1942152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty