Provider Demographics
NPI:1659485605
Name:ARTILES, LAURA MARGARITA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARGARITA
Last Name:ARTILES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:ARTILES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, PA
Mailing Address - Street 1:10300 SW 72ND ST
Mailing Address - Street 2:SUITE 153
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3012
Mailing Address - Country:US
Mailing Address - Phone:305-270-3737
Mailing Address - Fax:305-270-3736
Practice Address - Street 1:10300 SW 72ND ST
Practice Address - Street 2:SUITE 153
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3012
Practice Address - Country:US
Practice Address - Phone:305-270-3737
Practice Address - Fax:305-270-3736
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0005426103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY0005426OtherMEDICAL LICENSE