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General NPI Number Information
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NPI Number | 1285988774
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Entity Type | Individual
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Provider Name | LAURIE RICHARDSON ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 601 N FLAMINGO RD SUITE 304
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1015
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Country | US
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Telephone | 954-433-3114
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Fax | 954-433-1179
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Provider Business Mailing Address
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Address Line | 4960 SW 72ND AVE SUITE 406
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City | MIAMI
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State | FL
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Zip | 33155-5544
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Country | US
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Telephone | 305-662-5200
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Fax | 305-284-7948
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP1458262
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License Number State | FL
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