Provider Demographics
NPI:1932453123
Name:LAWRENCE A. SCHIFFMAN, DO, FAOCD, PL
Entity Type:Organization
Organization Name:LAWRENCE A. SCHIFFMAN, DO, FAOCD, PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHIFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-735-9474
Mailing Address - Street 1:3650 NW 82ND AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6694
Mailing Address - Country:US
Mailing Address - Phone:305-735-9474
Mailing Address - Fax:786-472-2717
Practice Address - Street 1:3650 NW 82ND AVE STE 201
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6662
Practice Address - Country:US
Practice Address - Phone:305-735-9474
Practice Address - Fax:786-472-2717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-09
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8835207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1386622397OtherORGANIZATION NPI
FL020718400Medicaid