Provider Demographics
NPI:1083796148
Name:SZYDLOWSKI, LAURA J (MS, RN, CNP)
Entity Type:Individual
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First Name:LAURA
Middle Name:J
Last Name:SZYDLOWSKI
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Gender:F
Credentials:MS, RN, CNP
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Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:2100 VIA BELLA BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-5429
Practice Address - Country:US
Practice Address - Phone:813-929-3516
Practice Address - Fax:813-355-5046
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2015-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9328176363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004664100Medicaid
FL004664100Medicaid