Provider Demographics
NPI:1417025719
Name:THOMAS, LAUREN ZIMMERMAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ZIMMERMAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3600 WASHINGTON ST
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8216
Mailing Address - Country:US
Mailing Address - Phone:954-518-5007
Mailing Address - Fax:954-518-5510
Practice Address - Street 1:2900 CORPORATE WAY
Practice Address - Street 2:STE D
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3925
Practice Address - Country:US
Practice Address - Phone:954-276-5572
Practice Address - Fax:954-985-7049
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8169103G00000X, 103TC0700X
DCPSY1000616103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical