Basic Information
| Provider Information | |||||||||
| NPI: | 1831618958 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAUB | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | KELLY | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 581 BRANTLEY TERRACE WAY UNIT 105 | ||||||||
| Address2: | |||||||||
| City: | ALTAMONTE SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327140821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3524304722 | ||||||||
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| Practice Location | |||||||||
| Address1: | 305 E OAK ST | ||||||||
| Address2: | |||||||||
| City: | APOPKA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327034352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078802266 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2017 | ||||||||
| LastUpdateDate: | 09/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | PTA27696 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.