Provider Demographics
NPI:1265777486
Name:LAWRENCE SCHEPPS DPM PA
Entity type:Organization
Organization Name:LAWRENCE SCHEPPS DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-641-7666
Mailing Address - Street 1:7800 W OAKLAND PARK BLVD BLDG A
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6741
Mailing Address - Country:US
Mailing Address - Phone:954-741-3303
Mailing Address - Fax:954-746-5818
Practice Address - Street 1:7800 W OAKLAND PARK BLVD BLDG A
Practice Address - Street 2:SUITE 100
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6741
Practice Address - Country:US
Practice Address - Phone:954-741-3303
Practice Address - Fax:954-746-5818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1003305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390090800Medicaid
FLT55437Medicare UPIN
FL390090800Medicaid