Provider Demographics
NPI:1316995764
Name:FREE, LAWRENCE ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ROBERT
Last Name:FREE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 TYRONE BLVD N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-7125
Mailing Address - Country:US
Mailing Address - Phone:727-345-7427
Mailing Address - Fax:727-347-1172
Practice Address - Street 1:500 TYRONE BLVD N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-7125
Practice Address - Country:US
Practice Address - Phone:727-345-7427
Practice Address - Fax:727-347-1172
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0001688111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH1688OtherSTATE LICENSE NUMBER
FL050222700Medicaid
FLCH1688OtherSTATE LICENSE NUMBER
FL89171Medicare ID - Type Unspecified