Provider Demographics
NPI:1457589921
Name:MEINER, LAWRENCE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:
Last Name:MEINER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 GRAND MESSINA CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-7104
Mailing Address - Country:US
Mailing Address - Phone:917-567-2896
Mailing Address - Fax:
Practice Address - Street 1:8404 GRAND MESSINA CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-7104
Practice Address - Country:US
Practice Address - Phone:917-567-2896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004301363AS0400X
FL9111483363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty