Provider Demographics
NPI:1982292017
Name:BRITO, LAUREN MACIEL
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MACIEL
Last Name:BRITO
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 1:7301 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2919
Mailing Address - Country:US
Mailing Address - Phone:954-748-2500
Mailing Address - Fax:
Practice Address - Street 1:7301 N UNIVERSITY DR STE 105
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2909
Practice Address - Country:US
Practice Address - Phone:954-748-2500
Practice Address - Fax:954-742-5661
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant