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Individual

DR. LAURENCE HARVEY BRENNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3030 HARDEN BLVD, LAKELAND, FL 33803-7952
(863) 687-1250
(863) 687-1258
Mailing address
232 CYPRESS HILLS WAY, DELAND, FL 32724-7352
(407) 489-8524
(386) 624-6297

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
ME91864
FL
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
ME91864
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
ME91864
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274526700
FL
01
52154A
MEDICARE PROVIDER
FL
01
6137800001
MEDICARE NSC
FL
01
K7473
MEDICARE GROUP PROVIDER
FL
Enumeration date
05/05/2006
Last updated
07/30/2022
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