Provider Demographics
NPI:1255591145
Name:ARTABAZON, LAURA HABELOW (DO)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:HABELOW
Last Name:ARTABAZON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:LORRAINE
Other - Last Name:HABELOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2600 VETERANS WAY
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32408
Mailing Address - Country:US
Mailing Address - Phone:850-636-7000
Mailing Address - Fax:850-636-7060
Practice Address - Street 1:2600 VETERANS WAY
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32408
Practice Address - Country:US
Practice Address - Phone:850-636-7000
Practice Address - Fax:850-636-7060
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202481207R00000X
FLOS14243207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS14243OtherSTATE LICENSE