MEDICARE: MRS. LAURIE MICHELLE ADKINS PA-C

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	363AM0700X	Medical Physician Assistant		OH
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1457682825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURIE MICHELLE ADKINS PA-C

Provider Business Mailing Address
First Line	:	13935 LANDSTAR BLVD STE 150
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-5533
Country	:	US
Telephone Number	:	330-904-7377
Fax Number	:

Provider Business Practice Location Address
First Line	:	13935 LANDSTAR BLVD STE 150
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-5533
Country	:	US
Telephone Number	:	216-445-4545
Fax Number	:

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

Provider Enumeration Date	:	01/24/2010
Last Update Date	:	02/21/2023

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