Provider Demographics
NPI:1013311901
Name:WIEBER, LAURA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:WIEBER
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1947 ESSEX PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3214
Mailing Address - Country:US
Mailing Address - Phone:727-804-7508
Mailing Address - Fax:
Practice Address - Street 1:1947 ESSEX PL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3214
Practice Address - Country:US
Practice Address - Phone:727-804-7508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9310917363LF0000X
FLAPRN9310917363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013911700Medicaid