MEDICARE: AUDREY LA NOCE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	OS14411	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346676004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY LA NOCE D.O.

Provider Business Mailing Address
First Line	:	500 E BROWARD BLVD STE 1710
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33394-3005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E BROWARD BLVD # 1701
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33394-3000
Country	:	US
Telephone Number	:	954-848-2814
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2013
Last Update Date	:	08/07/2020

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