Healthcare Provider Details

I. General information

NPI: 1780180869
Provider Name (Legal Business Name): LAUREN JOY FARLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 ROLLING ACRES RD STE A
LADY LAKE FL
32159-5048
US

IV. Provider business mailing address

539 ROLLING ACRES RD STE A
LADY LAKE FL
32159-5048
US

V. Phone/Fax

Practice location:
  • Phone: 352-561-7346
  • Fax: 352-915-7346
Mailing address:
  • Phone: 352-561-8742
  • Fax: 352-915-7346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME168576
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: