Provider Demographics
NPI:1104909548
Name:YEUNG, LAWRENCE LUEN SHEAN (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:LUEN SHEAN
Last Name:YEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:PO BOX 100247
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0247
Mailing Address - Country:US
Mailing Address - Phone:352-273-6815
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0247
Practice Address - Country:US
Practice Address - Phone:352-273-6815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2011-07-07
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2010-01-13
Provider Licenses
StateLicense IDTaxonomies
MO2010005865208800000X
FLME106832208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003591200Medicaid
FLFA060ZMedicare PIN