Individual
LAWRENCE SCOTT ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4485 FURLING LN, DESTIN, FL 32541-5331
(850) 654-1194
(850) 654-3380
Mailing address
4485 FURLING LN, DESTIN, FL 32541-5331
(850) 654-1194
(850) 654-3380
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME87360
FL
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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