Healthcare Provider Details

I. General information

NPI: 1669969911
Provider Name (Legal Business Name): LAURI DEANE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2018
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 N FEDERAL HWY
BOCA RATON FL
33487-3200
US

IV. Provider business mailing address

6201 N FEDERAL HWY
BOCA RATON FL
33487-3200
US

V. Phone/Fax

Practice location:
  • Phone: 954-536-5353
  • Fax: 949-695-4633
Mailing address:
  • Phone: 954-536-5353
  • Fax: 949-695-4633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9327907
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: