Provider Demographics
NPI:1801456694
Name:LAINEZ, PAULETTE (CERTIFIED TRAINERS)
Entity type:Individual
Prefix:MRS
First Name:PAULETTE
Middle Name:
Last Name:LAINEZ
Suffix:
Gender:F
Credentials:CERTIFIED TRAINERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 SW 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6234
Mailing Address - Country:US
Mailing Address - Phone:954-934-7987
Mailing Address - Fax:
Practice Address - Street 1:3731 SW 43RD AVE
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-6234
Practice Address - Country:US
Practice Address - Phone:954-934-7987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLT207261171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor