MEDICARE: LAUREN TRONCOSO WEST LMFT

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	106H00000X	Marriage & Family Therapist	MT4421	FL

General Provider Information

NPI Number	:	1356078158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN TRONCOSO WEST LMFT

Provider Business Mailing Address
First Line	:	13444 GRAN BAY PKWY APT 720
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-7425
Country	:	US
Telephone Number	:	954-707-1269
Fax Number	:

Provider Business Practice Location Address
First Line	:	1138 EDGEWOOD AVE S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-5369
Country	:	US
Telephone Number	:	352-389-1920
Fax Number	:

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

Provider Enumeration Date	:	08/02/2022
Last Update Date	:	03/22/2024

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Directions to “ LAUREN TRONCOSO WEST LMFT” Practice Location

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