Provider Demographics
NPI:1114705654
Name:PERSAD, LAURA JACQUELINE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JACQUELINE
Last Name:PERSAD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16210 SW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5201
Mailing Address - Country:US
Mailing Address - Phone:954-616-7320
Mailing Address - Fax:
Practice Address - Street 1:16210 SW 27TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-5201
Practice Address - Country:US
Practice Address - Phone:954-616-7320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife