Healthcare Provider Details

I. General information

NPI: 1497148423
Provider Name (Legal Business Name): LAUREL FRENCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 03/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4127 SE 23RD AVE
OCALA FL
34480-7167
US

IV. Provider business mailing address

4127 SE 23RD AVE
OCALA FL
34480-7167
US

V. Phone/Fax

Practice location:
  • Phone: 352-426-1689
  • Fax:
Mailing address:
  • Phone: 352-426-1689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License NumberCRT 10637
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2471R0002X
TaxonomyRadiation Therapy Radiologic Technologist
License NumberCRT 10637
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: