Provider Demographics
NPI:1164844015
Name:LAURENCIN, LEANA (ARNP)
Entity Type:Individual
Prefix:
First Name:LEANA
Middle Name:
Last Name:LAURENCIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 NE 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5805
Mailing Address - Country:US
Mailing Address - Phone:305-891-8850
Mailing Address - Fax:305-895-5771
Practice Address - Street 1:1050 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5805
Practice Address - Country:US
Practice Address - Phone:305-891-8850
Practice Address - Fax:305-895-5771
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1802322314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility