Individual
MRS. JANIS S LAWRENCE-JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1921 WALDEMERE ST, SUITE 306, SARASOTA, FL 34239-2943
(941) 917-8722
(941) 917-8727
Mailing address
1921 WALDEMERE ST, SUITE 306, SARASOTA, FL 34239-2943
(941) 917-8722
(941) 917-8727
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
OS 12060
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HN486Z
MEDICARE PTAN
FL
Enumeration date
06/29/2009
Last updated
11/07/2013
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