Provider Demographics
NPI:1548595549
Name:LAFLEUR, MICHAEL BRANDON (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BRANDON
Last Name:LAFLEUR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 W GORE ST
Mailing Address - Street 2:SUITE 511
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1134
Mailing Address - Country:US
Mailing Address - Phone:407-423-7172
Mailing Address - Fax:407-423-9505
Practice Address - Street 1:32 W GORE ST
Practice Address - Street 2:SUITE 511
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1134
Practice Address - Country:US
Practice Address - Phone:407-423-7172
Practice Address - Fax:407-423-9505
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105220363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical