Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME47247 | FL |
NPI | 1003812363 |
---|---|
Provider Name | Dr. Lawrence Stephen Burns |
First Address | Davie, FL 33325-4901 |
Second Address | Hollywood, FL 33021-5424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 18/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D50792 | (02) | FL |