| Dr Lauzurique Phd Pa | |
|
209 Cobalt Dr Kissimmee FL 34758-3006 | |
| (787) 528-5560 | |
| Not Available |
| Full Name | Dr Lauzurique Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 209 Cobalt Dr, Kissimmee, Florida |
| Authorized Official Name and Position | Carmen Lauzurique Gonzalez (PRESIDENT) |
| Authorized Official Contact | 7875285560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lauzurique Phd Pa 209 Cobalt Dr Kissimmee FL 34758-3006 Ph: (787) 528-5560 | Dr Lauzurique Phd Pa 209 Cobalt Dr Kissimmee FL 34758-3006 Ph: (787) 528-5560 |
| NPI Number | 1215641295 |
|---|---|
| Provider Enumeration Date | 01/13/2023 |
| Last Update Date | 01/23/2024 |
| Certification Date | 01/23/2024 |
| Medicare PECOS PAC ID | 3375916331 |
|---|---|
| Medicare Enrollment ID | O20230222002806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215641295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carmen R Lauzurique Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598089229 PECOS PAC ID: 0648409508 Enrollment ID: I20200803001592 |
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