Lawrence P Fuller, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC00797 Issued in FL

Practice address

703 N Main St
Kissimmee, FL 34744-5265

Phone

(407) 846-2020

Fax

(407) 846-8039

NPI assigned

Aug 24, 2005

Last updated

Feb 26, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Lawrence P Fuller OD

  • Optometrist
  • Kissimmee, FL
  • NPI 1154596948
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1447243589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N MAIN ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445265",
            "telephone_number": "407-846-2020",
            "fax_number": "407-846-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N MAIN ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445265",
            "telephone_number": "407-846-2020",
            "fax_number": "407-846-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LAWRENCE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC00797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "596166473",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leisy Iris Fuentes Cansino, RBT
• Michelle Ivette Fuentes Caraballo
• Argeny Fuentes
• Victoria R Fuentes
• Chiara Fuller, LCSW
• Functional Physical Therapy (Bridge of Hope)
• Fundacion Hablando de Mujer a Mujer, Inc
• Isis Funez
• Jessica Fuoss, LMHC
• Nicholas Fusco

• Optometrist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.