Provider Demographics
NPI:1891243283
Name:LAGUERRE, LIZ
Entity Type:Individual
Prefix:
First Name:LIZ
Middle Name:
Last Name:LAGUERRE
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 1:4670 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-5640
Mailing Address - Country:US
Mailing Address - Phone:561-433-8900
Mailing Address - Fax:561-433-4117
Practice Address - Street 1:4670 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-5640
Practice Address - Country:US
Practice Address - Phone:561-433-8900
Practice Address - Fax:561-433-4117
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109732363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant