Provider Demographics
NPI:1548412083
Name:TROUP, LAURIE A (DO)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:TROUP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13386 KENT ST
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3929
Mailing Address - Country:US
Mailing Address - Phone:239-529-4100
Mailing Address - Fax:954-510-2086
Practice Address - Street 1:501 GOODLETTE RD N STE A103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5663
Practice Address - Country:US
Practice Address - Phone:239-529-4100
Practice Address - Fax:954-510-2086
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11799207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGL297ZOtherMEDICARE PTAN