Individual
DR. JIMMY J.S. LAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 TEQUESTA DR, DESTIN, FL 32541-5715
(210) 488-8203
Mailing address
325 TEQUESTA DR, DESTIN, FL 32541-5715
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME105422
FL
Other
Enumeration date
02/14/2006
Last updated
05/16/2013
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