Individual
DR. LAWRENCE STEVEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
4422 E COLUMBUS DR., TAMPA, FL 33605
(813) 384-4010
(813) 984-8419
Mailing address
4422 E COLUMBUS DR., TAMPA, FL 33605
(813) 384-4010
(813) 984-8419
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
ME103702
FL
208800000X
Urology Physician
ME103702
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002444200
—
FL
Enumeration date
04/06/2009
Last updated
04/02/2013
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