Individual
KEITH LAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13681 DOCTORS WAY, FORT MYERS, FL 33912-4300
(239) 343-3292
(239) 343-3695
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(393) 433-2922
(239) 343-3695
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA07304700
NJ
207P00000X
Emergency Medicine Physician
ME79508
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257969300
—
FL
01
—
2734337000
AMERIHEALTH
NJ
01
—
49485
BLUESHIELD
FL
05
—
8240906
—
NJ
Enumeration date
05/24/2005
Last updated
06/15/2022
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