Provider Demographics
NPI:1831196922
Name:LAUFER, FREDERICK JAMES (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:JAMES
Last Name:LAUFER
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 1:23625 COMMERCE PARK
Mailing Address - Street 2:#204
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5845
Mailing Address - Country:US
Mailing Address - Phone:216-255-5700
Mailing Address - Fax:216-255-5701
Practice Address - Street 1:6315 AMBERWOOD DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3737
Practice Address - Country:US
Practice Address - Phone:216-255-5735
Practice Address - Fax:216-255-5701
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162764-12085R0202X
FLME608842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1537748Medicaid
1831196922OtherTRICARE PRIME
300100047OtherRR
SC194202Medicaid
FL376437100Medicaid
FL17738OtherBCBS
NY00898531Medicaid
OH2771175Medicaid
SC194202Medicaid
OH2771175Medicaid
FL17738OtherBCBS
FL17738OMedicare PIN
A62851Medicare UPIN
FL17738VMedicare ID - Type Unspecified