MEDICARE: MISS KARINA GRACE LAUCIELLO DNP, APRN, CRNA

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	390200000X	Student in an Organized Health Care Education/Training Program	RN9390765	FL
2	367500000X	Certified Registered Nurse Anesthetist	11017220	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	:	1407426505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KARINA GRACE LAUCIELLO DNP, APRN, CRNA

Provider Business Mailing Address
First Line	:	1000 RIVER REACH DR APT 221
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-1167
Country	:	US
Telephone Number	:	954-665-9703
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 RIVER REACH DR APT 221
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-1167
Country	:	US
Telephone Number	:	954-665-9703
Fax Number	:

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

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	03/19/2025

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