Black, Lawrence Richard
Black, Lawrence Richard is an individual health care provider with primary practice located at 13691 Metro Pkwy 350, Fort Myers FL 33912-4327. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Black, Lawrence Richard can be contacted via phone (239) 768-5313.Contact Information
Primary practice address
13691 Metro Pkwy 350
Fort Myers FL 33912-4327
Phone: (239) 768-5313
Fax: (239) 768-9559
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 055736 | Florida |
Profile Details
| NPI number | 1114035284 |
|---|---|
| LBN Legal business name | Black, Lawrence Richard |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 28th, 2006 |
| Last updated | Apr 25th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114035284 | NPPES |
| Florida | Other | 2972830 | CIGNA |
| Florida | MEDICAID | 007256700 | CIGNA |
| Florida | Other | 80628 | CIGNA |
| Florida | Other | 15649 | CIGNA |
| Florida | Other | 4478694 | CIGNA |
| Florida | MEDICAID | 375522300 | CIGNA |
| Florida | Other | P01192863 | CIGNA |
| Florida | Other | P304402 | CIGNA |
| Florida | Other | 212724 | CIGNA |
| Florida | Other | 80628 | CIGNA |
| Florida | Other | P946386 | CIGNA |
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