Provider Demographics
NPI:1528057775
Name:SEIGEL, LAWRENCE A (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:SEIGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:14003 LAKESHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7124
Mailing Address - Country:US
Mailing Address - Phone:727-868-9442
Mailing Address - Fax:727-862-6210
Practice Address - Street 1:14003 LAKESHORE BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7124
Practice Address - Country:US
Practice Address - Phone:727-868-9442
Practice Address - Fax:727-862-6210
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39233207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066452900Medicaid
FL0805235OtherUNITED HEALTHCARE
FL180025713OtherRR MEDICARE
FL51165OtherBCBSFL
FL180025713OtherRR MEDICARE
FL0805235OtherUNITED HEALTHCARE