Provider Demographics
NPI:1891676748
Name:FLOYD, LAWRENCE FITZGERALD (PSS)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:FITZGERALD
Last Name:FLOYD
Suffix:
Gender:M
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3931
Mailing Address - Country:US
Mailing Address - Phone:800-355-4615
Mailing Address - Fax:
Practice Address - Street 1:2701 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3931
Practice Address - Country:US
Practice Address - Phone:800-355-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-NQKGMV175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty