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General NPI Number Information
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NPI Number | 1750932976
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Entity Type | Individual
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Provider Name | GLORIMAR LAUREANO
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Gender | Female
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Dates
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Enumeration Date | 09/28/2019
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Last Update Date | 09/28/2019
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Provider Practice Location Address
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Address Line | 9468 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32817-4150
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Country | US
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Telephone | 407-281-3803
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Fax |
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Provider Business Mailing Address
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Address Line | 4826 S SEMORAN BLVD APT 1008
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City | ORLANDO
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State | FL
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Zip | 32822-2363
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Country | US
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Telephone | 787-610-8126
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI3988
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License Number State | FL
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