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NPI Code Detail

MEDICARE: DR. MARISA V LAURORA D.O.

MEDICARE: DR. MARISA V LAURORA D.O.
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
1207P00000XEmergency Medicine Physician0063397CO
2207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianDR.0063397CO

General Provider Information

NPI Number : 1811948102
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARISA V LAURORA D.O.
Provider Business Mailing Address
First Line : PO BOX 10100
Second Line :
City : DELTA
State : CO
Zip : 81416-0008
Country : US
Telephone Number : 970-874-7681
Fax Number : 970-874-2254
Provider Business Practice Location Address
First Line : 1501 E 3RD ST
Second Line :
City : DELTA
State : CO
Zip : 81416-2815
Country : US
Telephone Number : 970-874-7681
Fax Number : 970-874-2254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 02/14/2023

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Directions to “ DR. MARISA V LAURORA D.O.” Practice Location

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