Provider Demographics
NPI:1326029059
Name:LAULO, DONNA
Entity Type:Individual
Prefix:MR
First Name:DONNA
Middle Name:
Last Name:LAULO
Suffix:
Gender:F
Credentials:
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6TH MEDICAL GROUP,6 MDOS/SGOPF
Mailing Address - Street 2:8415 BAYSHORE BLVD
Mailing Address - City:MACDILL AFB
Mailing Address - State:FL
Mailing Address - Zip Code:33621-1607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6TH MEDICAL GROUP, 6 MDOS/SGOPF
Practice Address - Street 2:8415 BAYSHORE BLVD
Practice Address - City:MACDILL AFB
Practice Address - State:FL
Practice Address - Zip Code:33621-1607
Practice Address - Country:US
Practice Address - Phone:813-827-9248
Practice Address - Fax:813-827-9264
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant