Provider Demographics
NPI:1336247287
Name:LAURENT, LILIANE (MPH,LDN)
Entity Type:Individual
Prefix:MRS
First Name:LILIANE
Middle Name:
Last Name:LAURENT
Suffix:
Gender:F
Credentials:MPH,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11061 NW 46TH DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2142
Mailing Address - Country:US
Mailing Address - Phone:954-575-5835
Mailing Address - Fax:
Practice Address - Street 1:225 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4616
Practice Address - Country:US
Practice Address - Phone:561-274-3100
Practice Address - Fax:561-274-3144
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL133N00000X133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist