Healthcare Provider Details

I. General information

NPI: 1427062140
Provider Name (Legal Business Name): DEBORAH L.S. LAUREN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 QUANTUM LAKES DR
BOYNTON BEACH FL
33426-8324
US

IV. Provider business mailing address

3205 TARAGROVE DR
TAMPA FL
33618-2544
US

V. Phone/Fax

Practice location:
  • Phone: 561-244-0200
  • Fax:
Mailing address:
  • Phone: 813-453-8383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN1244022
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN182148
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number730159
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number944239
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: