Healthcare Provider Details

I. General information

NPI: 1275347999
Provider Name (Legal Business Name): LAURAN MARIE DONOFRIO MSN, ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 1ST ST APT 3
INDIAN ROCKS BEACH FL
33785-2697
US

IV. Provider business mailing address

721 1ST ST APT 3
INDIAN ROCKS BEACH FL
33785-2697
US

V. Phone/Fax

Practice location:
  • Phone: 727-742-9193
  • Fax:
Mailing address:
  • Phone: 727-742-9193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11037477
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: