Provider Demographics
NPI:1558105825
Name:LAGUERRE, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
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 1:4000 HOLLYWOOD BLVD STE 555S
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6853
Mailing Address - Country:US
Mailing Address - Phone:407-969-9510
Mailing Address - Fax:
Practice Address - Street 1:746 SW 4TH ST UNIT 1
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-4902
Practice Address - Country:US
Practice Address - Phone:407-969-9510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver