Individual
LAWRENCE D SPACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
92 W MILLER ST, ORLANDO, FL 32806-2032
(321) 841-5104
(321) 841-6871
Mailing address
92 W MILLER ST, ORLANDO, FL 32806-2032
(321) 841-5104
(321) 841-6871
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME74105
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253085600
—
FL
Enumeration date
08/25/2006
Last updated
08/23/2024
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