Provider Demographics
NPI:1750932976
Name:LAUREANO, GLORIMAR
Entity type:Individual
Prefix:
First Name:GLORIMAR
Middle Name:
Last Name:LAUREANO
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 1:4826 S SEMORAN BLVD APT 1008
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-2363
Mailing Address - Country:US
Mailing Address - Phone:787-610-8126
Mailing Address - Fax:
Practice Address - Street 1:9468 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4150
Practice Address - Country:US
Practice Address - Phone:407-281-3803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-28
Last Update Date:2019-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI39882355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant