Lawrence B. Blumberg, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

ME-0030528 Issued in FL

Practice address

2359 Twin Bay VW
Fort Walton Beach, FL 32547-1897

Phone

(850) 863-4194

NPI assigned

Mar 15, 2007

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720112238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2359 TWIN BAY VW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471897",
            "telephone_number": "850-863-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2359 TWIN BAY VW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471897",
            "telephone_number": "850-863-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMBERG",
        "first_name": "LAWRENCE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME-0030528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BLM First Assistant
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• Brian Keith Boelk, MSW
• Rebekah Elizabeth Boes, LMHC
• Elizabeth Johnson Boeve, RN
• Telisha Boggan, CNA

• Otolaryngology Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Otolaryngology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.