Provider Demographics
NPI:1942409941
Name:KATHERINE LEE SMITH LAUNER P.A.
Entity Type:Organization
Organization Name:KATHERINE LEE SMITH LAUNER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LAUNER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-855-7454
Mailing Address - Street 1:5401 S CONGRESS AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6637
Mailing Address - Country:US
Mailing Address - Phone:954-384-5329
Mailing Address - Fax:954-384-0987
Practice Address - Street 1:11350 61ST ST N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412-1818
Practice Address - Country:US
Practice Address - Phone:561-855-7454
Practice Address - Fax:561-855-7454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1640542363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003945100Medicaid
FLQ40471Medicare UPIN