MEDICARE: DR. LAURA B SUMMERS M.D.

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	207RR0500X	Rheumatology Physician	ME82342	FL

General Provider Information

NPI Number	:	1992753503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA B SUMMERS M.D.

Provider Business Mailing Address
First Line	:	3160 SOUTHGATE COMMERCE BLVD
Second Line	:	STE30
City	:	ORLANDO
State	:	FL
Zip	:	32806-8549
Country	:	US
Telephone Number	:	407-859-4540
Fax Number	:	407-859-3815

Provider Business Practice Location Address
First Line	:	3160 SOUTHGATE COMMERCE BLVD
Second Line	:	STE30
City	:	ORLANDO
State	:	FL
Zip	:	32806-8549
Country	:	US
Telephone Number	:	407-859-4540
Fax Number	:	407-859-3815

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	10/10/2011

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