Provider Demographics
NPI:1659686665
Name:LEVERENZ, LAURYN J (CRNA)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:J
Last Name:LEVERENZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 862810
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-2810
Mailing Address - Country:US
Mailing Address - Phone:866-632-7346
Mailing Address - Fax:866-665-2702
Practice Address - Street 1:1130 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-1041
Practice Address - Country:US
Practice Address - Phone:866-632-7346
Practice Address - Fax:866-665-2702
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9227649367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered