Healthcare Provider Details

I. General information

NPI: 1174556765
Provider Name (Legal Business Name): LAURA ELAINE LAJOS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 07/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 UNIVERSITY PKWY STE 219
SARASOTA FL
34243-2809
US

IV. Provider business mailing address

2415 UNIVERSITY PKWY STE 219
SARASOTA FL
34243-2809
US

V. Phone/Fax

Practice location:
  • Phone: 800-687-1938
  • Fax: 727-495-7233
Mailing address:
  • Phone: 800-687-1938
  • Fax: 727-495-7233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number963
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY8143
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: