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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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