Provider Demographics
NPI:1811572514
Name:LAWRENCE, CAITLYN MARIE
Entity Type:Individual
Prefix:MISS
First Name:CAITLYN
Middle Name:MARIE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7764 LOWER GATEWAY LOOP UNIT 1933
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7216
Mailing Address - Country:US
Mailing Address - Phone:724-884-6334
Mailing Address - Fax:
Practice Address - Street 1:7764 LOWER GATEWAY LOOP UNIT 1933
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7216
Practice Address - Country:US
Practice Address - Phone:724-884-6334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program