Individual
LAVERN KEITT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6373
Mailing address
1407 ESSEX DR, ORANGEBURG, SC 29118-2010
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
140595
FL
Other
Enumeration date
04/11/2016
Last updated
01/29/2020
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