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LAWRENCE CRAIG TILL PA-C
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1497787063
Individual Registrant: LAWRENCE CRAIG TILL PA-C
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
15932 E HIGHWAY 40 SILVER SPRINGS, FL 34488-5144 US
Tel: 352-625-7777 Fax: 352-625-1970
Tel: 352-625-7777 Fax: 352-625-1970
Contact information for business:
15932 E HIGHWAY 40 SILVER SPRINGS, FL 34488-5144 US
Tel: 352-625-7777 Fax: 352-625-1970
Tel: 352-625-7777 Fax: 352-625-1970
Registration Information:
NPI: 1497787063
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | FL | PA9101867 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 291156600 | FL | 05 |
