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General NPI Number Information
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NPI Number | 1972279263
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Entity Type | Individual
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Provider Name | LAURYN HEFNER
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Gender | Female
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 1921 ORTEGA ST
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City | NAVARRE
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State | FL
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Zip | 32566-4111
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Country | US
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Telephone | 850-936-8919
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Fax |
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Provider Business Mailing Address
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Address Line | 2006 CAMBRIDGE PARK DR
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City | GULF BREEZE
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State | FL
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Zip | 32563-0101
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT40455
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License Number State | FL
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