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General NPI Number Information
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NPI Number | 1205631603
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Entity Type | Individual
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Provider Name | MARTINE LAUTURE
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Gender | Female
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 249 FERDON CIR
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-2102
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Country | US
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Telephone | 941-204-4380
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Fax |
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Provider Business Mailing Address
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Address Line | 249 FERDON CIR
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-2102
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Country | US
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Telephone | 941-204-4380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 5171844
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.028248
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License Number State | IL
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