Healthcare Provider Details

I. General information

NPI: 1336579283
Provider Name (Legal Business Name): LAUREN R PULSIFER HAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2013
Last Update Date: 11/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16681 MCGREGOR BLVD SUITE 103
FORT MYERS FL
33908-3830
US

IV. Provider business mailing address

2510 E SUNSET RD UNIT 5-260
LAS VEGAS NV
89120-3511
US

V. Phone/Fax

Practice location:
  • Phone: 239-482-6350
  • Fax: 239-482-6347
Mailing address:
  • Phone: 702-798-0113
  • Fax: 866-291-5242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS 4947
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: