Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME0068405 | FL |
NPI | 1003879453 |
---|---|
Provider Name | Lawrence S Hakim |
First Address | Weston, FL 33331-3609 |
Second Address | Weston, FL 33331-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 03/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G11505 | (02) | FL |