Healthcare Provider Details

I. General information

NPI: 1376477323
Provider Name (Legal Business Name): LAUREN AUDREY FLETCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3898 VIA POINCIANA STE 17
GREENACRES FL
33467-2951
US

IV. Provider business mailing address

311 OREGON LN
BOCA RATON FL
33487-1431
US

V. Phone/Fax

Practice location:
  • Phone: 561-376-2573
  • Fax:
Mailing address:
  • Phone: 561-886-7747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13335
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: