Healthcare Provider Details

I. General information

NPI: 1225410574
Provider Name (Legal Business Name): JULIEANNE LAURENTE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11011 SHERIDAN ST STE 106
HOLLYWOOD FL
33026-1501
US

IV. Provider business mailing address

16766 SW 36TH CT
MIRAMAR FL
33027-4553
US

V. Phone/Fax

Practice location:
  • Phone: 954-435-0101
  • Fax: 954-435-0125
Mailing address:
  • Phone: 954-812-0117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11039185
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: