Individual
OLIVER BENNETT LAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 N 35TH AVE STE 555, HOLLYWOOD, FL 33021-5431
(954) 265-0072
(954) 981-0188
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
(954) 276-5685
(954) 985-7074
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
ME130985
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020077500
—
FL
Enumeration date
09/07/2006
Last updated
02/02/2022
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