Healthcare Provider Details

I. General information

NPI: 1447089529
Provider Name (Legal Business Name): LAUREN ELISE LEARN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 N FEDERAL HWY STE 100
FORT LAUDERDALE FL
33308-6264
US

IV. Provider business mailing address

3536 N FEDERAL HWY STE 100
FORT LAUDERDALE FL
33308-6264
US

V. Phone/Fax

Practice location:
  • Phone: 954-380-8411
  • Fax:
Mailing address:
  • Phone: 954-380-8411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11034303
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number11034303
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: