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General NPI Number Information
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NPI Number | 1750408613
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Entity Type | Individual
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Provider Name | LAURA ELISE REINERTSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2007
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 21150 BISCAYNE BLVD SUITE 200
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City | AVENTURA
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State | FL
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Zip | 33180-1226
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Country | US
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Telephone | 305-932-8989
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Fax | 305-932-1118
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Provider Business Mailing Address
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Address Line | 21150 BISCAYNE BLVD SUITE 200
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City | AVENTURA
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State | FL
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Zip | 33180-1226
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Country | US
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Telephone | 305-932-8989
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Fax | 305-932-1118
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME78533
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License Number State | FL
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