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 |
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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 |
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Provider Enumeration Date | 01/13/2023 |
Last Update Date | 01/23/2024 |
Certification Date | 01/23/2024 |
Medicare PECOS PAC ID | 3375916331 |
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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 |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1598089229 PECOS PAC ID: 0648409508 Enrollment ID: I20200803001592 |
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