Provider Demographics
NPI:1649814575
Name:GADZINSKI, LAURA MICHELLE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MICHELLE
Last Name:GADZINSKI
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 1:16358 73RD CT N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3014
Mailing Address - Country:US
Mailing Address - Phone:561-389-2691
Mailing Address - Fax:
Practice Address - Street 1:16932 79TH CT N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3024
Practice Address - Country:US
Practice Address - Phone:561-792-3115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide