MEDICARE: MS. BERTINE JEAN LAURENT NP

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	363L00000X	Nurse Practitioner	359149	NY
2	363LF0000X	Family Nurse Practitioner	11035690	FL
3	363L00000X	Nurse Practitioner	AP70087650	WA
4	363L00000X	Nurse Practitioner	336328	AZ

General Provider Information

NPI Number	:	1881415123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BERTINE JEAN LAURENT NP

Provider Business Mailing Address
First Line	:	3030 E SEMORAN BLVD STE 264
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-5953
Country	:	US
Telephone Number	:	321-280-3810
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 E SEMORAN BLVD STE 264
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-5953
Country	:	US
Telephone Number	:	321-280-3810
Fax Number	:

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

Provider Enumeration Date	:	10/19/2024
Last Update Date	:	03/18/2026

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