MEDICARE: LAUREN LAGARON DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 31565	FL

General Provider Information

NPI Number	:	1548612237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN LAGARON DPT

Provider Business Mailing Address
First Line	:	12660 SW 116TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-4419
Country	:	US
Telephone Number	:	305-458-5340
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 S DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-2462
Country	:	US
Telephone Number	:	305-647-0909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2016
Last Update Date	:	07/06/2016

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