Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME95989 | FL |
N | 111NI0900X | Internist | ME95989 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME95989 | FL |
N | 207RG0300X | Geriatric Medicine | ME95989 | FL |
NPI | 1912040940 |
---|---|
Provider Name | Lawrence Stuart Greenfield |
First Address | Apollo Beach, FL 33572-3323 |
Second Address | Apollo Beach, FL 33572-3323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C29838 | (02) | PA |
MA97837 | (05) | PA |