Individual
JAMES X LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
612 N TAMIAMI TRL, RUSKIN, FL 33570-3769
(813) 645-3831
(813) 645-4402
Mailing address
612 N TAMIAMI TRL, RUSKIN, FL 33570-3769
(813) 645-3831
(813) 645-4402
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC001668
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078359500
—
FL
01
—
19445A
BCBS FLORIDA
FL
01
—
2200636
AETNA
FL
01
—
4317979
AETNA
FL
01
—
9600540
GHI
NY
Enumeration date
08/31/2005
Last updated
05/18/2020
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