Provider Demographics
NPI:1679540744
Name:FERBER, LAURENCE R (MD)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:R
Last Name:FERBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W HIGHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4717
Mailing Address - Country:US
Mailing Address - Phone:352-726-3646
Mailing Address - Fax:352-726-0079
Practice Address - Street 1:7062 S ALOYSIA AVE
Practice Address - Street 2:
Practice Address - City:FLORAL CITY
Practice Address - State:FL
Practice Address - Zip Code:34436-2844
Practice Address - Country:US
Practice Address - Phone:352-364-4038
Practice Address - Fax:352-419-4302
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME851102086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258062400Medicaid
FL266503400Medicaid
FL78746OtherBLUE CROSS BLUE SHIELD
FLP00006849OtherRR MEDICARE
FL38905Medicare PIN
FL266503400Medicaid