Organization
LAWRENCE F. FASS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE F. FASS MD (PRESIDENT)
(954) 776-7300
Entity
Organization
Contact information
Practice address
6405 N FEDERAL HWY, SUITE 101, FORT LAUDERDALE, FL 33308-1412
(954) 776-7300
(954) 776-7307
Mailing address
6405 N FEDERAL HWY, SUITE 101, FORT LAUDERDALE, FL 33308-1412
(954) 776-7300
(954) 776-7307
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME15850
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042255000
—
FL
01
—
D58354
UPIN
FL
Enumeration date
06/22/2011
Last updated
06/22/2011
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