Provider Demographics
NPI:1346226156
Name:HARPER, LAURA A (MD)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:HARPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2454 N MCMULLEN BOOTH RD
Mailing Address - Street 2:STE 601
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1353
Mailing Address - Country:US
Mailing Address - Phone:727-796-7705
Mailing Address - Fax:727-796-8764
Practice Address - Street 1:3268 66TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1511
Practice Address - Country:US
Practice Address - Phone:727-384-4000
Practice Address - Fax:727-343-3492
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 40080174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58896Medicare UPIN
FL79713YMedicare ID - Type Unspecified