Organization
L L AND B ELECTROCARIOGRAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE J LIEBERMAN M.D. (PARTNER)
(941) 792-0023
Entity
Organization
Contact information
Practice address
5307 12TH AVENUE DR W, BRADENTON, FL 34209-4229
(941) 792-0023
Mailing address
PO BOX 14718, BRADENTON, FL 34280-4718
(941) 792-0023
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63110
BLUECROSS BLUESHIELD
FL
Enumeration date
04/02/2007
Last updated
08/03/2007
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