Provider Demographics
NPI:1699771873
Name:TAYLOR, LAWRENCE CAROL JR (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:CAROL
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:540 MEDICAL OAKS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5995
Mailing Address - Country:US
Mailing Address - Phone:813-684-2211
Mailing Address - Fax:813-655-7669
Practice Address - Street 1:540 MEDICAL OAKS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5995
Practice Address - Country:US
Practice Address - Phone:813-684-2211
Practice Address - Fax:813-685-0895
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2022-04-26
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Provider Licenses
StateLicense IDTaxonomies
FLME 42257207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL042474900Medicaid
FL30780ZMedicare PIN
FL042474900Medicaid