Lauren Mikel Broadway, M.D.
Family Medicine in Venice, FL. Individual provider (NPI-1).
NPI number1811263643
StatusActive
Last updated in NPPESDec 30, 2021
Details
- NPI
- 1811263643
- Entity type
- Individual (NPI-1)
- Name
- Lauren Mikel Broadway
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 27, 2012
- Certification date
- Dec 30, 2021
- Last updated
- Dec 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | ME124016 | FL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
417 Commercial Ct Ste CVenice, FL 34292-1655
Phone 941-220-0300 · Fax 941-220-0400
Mailing address
417 Commercial Ct Ste CVenice, FL 34292-1655
Phone 941-220-0300 · Fax 941-220-0400
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