Provider Demographics
NPI:1730184045
Name:REESE, LAWRENCE T (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:T
Last Name:REESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10274 S.W. 26 STREET
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324
Mailing Address - Country:US
Mailing Address - Phone:954-243-1670
Mailing Address - Fax:305-933-9446
Practice Address - Street 1:21110 BISCAYNE BLVD
Practice Address - Street 2:STE 403
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1252
Practice Address - Country:US
Practice Address - Phone:305-933-9445
Practice Address - Fax:305-933-9446
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME29298207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA406183739OtherRAILROAD MEDICARE
GA406183739OtherRAILROAD MEDICARE
FL92990Medicare ID - Type Unspecified
D60280Medicare UPIN
FL92990AMedicare ID - Type Unspecified