Provider Demographics
NPI:1093058463
Name:PURDY, LAURA ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELLEN
Last Name:PURDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:ELLEN
Other - Last Name:SCHIESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6800 BIRD RD UNIT 650
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3708
Mailing Address - Country:US
Mailing Address - Phone:754-223-9851
Mailing Address - Fax:
Practice Address - Street 1:23693B CALABASAS RD STE 100
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1502
Practice Address - Country:US
Practice Address - Phone:818-493-7588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-01536207Q00000X, 207Q00000X
AZ56179207Q00000X
CAA158424207Q00000X, 207Q00000X
TN55905207Q00000X, 207Q00000X
MDD86185207Q00000X
IAMD-46566207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine