Provider Demographics
NPI:1831383686
Name:TANZINI, LAURA (DR PH)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:TANZINI
Suffix:
Gender:F
Credentials:DR PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 OCEAN FRONT DR
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-4241
Mailing Address - Country:US
Mailing Address - Phone:909-240-5096
Mailing Address - Fax:
Practice Address - Street 1:6 OCEAN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-3833
Practice Address - Country:US
Practice Address - Phone:909-240-5096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41330106H00000X
FLMT3457106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist