MEDICARE: LAURA RIZZO BRACEY ARNP

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	363LF0000X	Family Nurse Practitioner	11047913	FL

General Provider Information

NPI Number	:	1366456451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA RIZZO BRACEY ARNP

Provider Business Mailing Address
First Line	:	2202 STATE AVE STE 301
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4590
Country	:	US
Telephone Number	:	850-215-7071
Fax Number	:	850-215-7073

Provider Business Practice Location Address
First Line	:	2202 STATE AVE STE 2202
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-7601
Country	:	US
Telephone Number	:	850-215-7071
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	06/10/2026

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