Provider Demographics
NPI:1649693375
Name:NIELSEN, LAUREN MARGARET (PT, DPT,OCS, FAAOMPT)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MARGARET
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:PT, DPT,OCS, FAAOMPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MARGARET
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:801 WOODBURY RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4514
Mailing Address - Country:US
Mailing Address - Phone:716-870-8891
Mailing Address - Fax:
Practice Address - Street 1:801 WOODBURY RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4514
Practice Address - Country:US
Practice Address - Phone:407-373-6082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28963225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist