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General NPI Number Information
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NPI Number | 1790828440
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Entity Type | Organization
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Legal Business Name | LAURIE WELTON DO PA
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1627 US HIGHWAY 1 STE 208
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City | SEBASTIAN
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State | FL
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Zip | 32958-3464
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Country | US
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Telephone | 772-299-7009
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Fax | 772-562-7138
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Provider Business Mailing Address
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Address Line | 1627 US HIGHWAY 1 STE 208
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City | SEBASTIAN
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State | FL
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Zip | 32958-3464
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Country | US
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Telephone | 772-299-7009
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Fax | 772-562-7138
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURIE ANN WELTON
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Credential | D.O.
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Telephone | 772-299-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | OS8950
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License Number State | FL
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