MEDICARE: LAURA ARMSTRONG AND ASSOCIATES LLC

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	133V00000X	Registered Dietitian	ND4803	FL

General Provider Information

NPI Number	:	1811211345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA ARMSTRONG AND ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	513 NW FETTERBUSH WAY
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-3530
Country	:	US
Telephone Number	:	772-403-8126
Fax Number	:	772-403-8127

Provider Business Practice Location Address
First Line	:	850 NW FEDERAL HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-1019
Country	:	US
Telephone Number	:	772-403-8126
Fax Number	:	772-403-8127

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. LAURA A ARMSTRONG
Credential	:	RD, LD/N, CDE
Telephone Number	:	772-631-0690

Provider Enumeration Date	:	03/26/2010
Last Update Date	:	03/26/2010

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