Organization
LAWRENCE E BRODER M D P A
Active
Organization
LAWRENCE E BRODER M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE BRODER (PRESIDENT)
(305) 238-1212
Entity
Organization
Contact information
Practice address
45 NW 8TH ST, SUITE 104, HOMESTEAD, FL 33030-4452
(305) 246-5500
(305) 246-0081
Mailing address
8740 SW 182ND TER, VILLAGE OF PALMETTO BAY, FL 33157-5952
(305) 238-1212
(305) 238-8191
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
ME0027628
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210135
AMERIGROUP HMO
FL
01
—
221246
AVMED HMO
FL
05
—
370009700
—
FL
01
—
55027
JMH HMO
FL
Enumeration date
08/09/2006
Last updated
10/30/2008
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