Provider Demographics
NPI:1710977277
Name:LAUREANO, MILVIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MILVIA
Middle Name:
Last Name:LAUREANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 CHAMPIONS VUE LOOP UNIT 101
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33897-4852
Mailing Address - Country:US
Mailing Address - Phone:787-410-0058
Mailing Address - Fax:
Practice Address - Street 1:141 E CENTRAL AVE STE 100
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-6319
Practice Address - Country:US
Practice Address - Phone:888-414-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16124208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice