Healthcare Provider Details

I. General information

NPI: 1679530265
Provider Name (Legal Business Name): LAURA BURNS GAFFNEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34637 US HIGHWAY 19 N
PALM HARBOR FL
34684-2152
US

IV. Provider business mailing address

34637 US HIGHWAY 19 N
PALM HARBOR FL
34684-2152
US

V. Phone/Fax

Practice location:
  • Phone: 727-786-1673
  • Fax: 727-785-0284
Mailing address:
  • Phone: 727-786-1673
  • Fax: 727-785-0284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME102928
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME102928
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: