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Individual

LAWRENCE GERMAIN LAREAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 243-6164
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 243-6164

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD033012E
PA
2085R0202X
Diagnostic Radiology Physician
Primary
ME102931
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0011342970080
PA
Enumeration date
07/14/2005
Last updated
04/25/2024
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