Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | ME0045095 | FL |
NPI | 1225123482 |
---|---|
Provider Name | Lawrence E. Dorf |
First Address | Coral Springs, FL 33076-1704 |
Second Address | Coral Springs, FL 33076-1704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 19/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D63258 | (02) |