Healthcare Provider Details

I. General information

NPI: 1992886857
Provider Name (Legal Business Name): LAURA TEMPLETON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA T KEITH APRN

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12470 TELECOM DR STE 301
TEMPLE TERRACE FL
33637-0904
US

IV. Provider business mailing address

2501 N ORANGE AVE SUITE 235
ORLANDO FL
32804-4603
US

V. Phone/Fax

Practice location:
  • Phone: 813-871-8111
  • Fax:
Mailing address:
  • Phone: 407-303-2906
  • Fax: 407-303-7126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP3060102
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: