Provider Demographics
NPI:1124242029
Name:LAUVAO, LANNERY SIOELI (MD)
Entity type:Individual
Prefix:DR
First Name:LANNERY
Middle Name:SIOELI
Last Name:LAUVAO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18555 N 79TH AVE STE B101
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8372
Mailing Address - Country:US
Mailing Address - Phone:623-512-4326
Mailing Address - Fax:623-594-2252
Practice Address - Street 1:18555 N 79TH AVE STE B101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8372
Practice Address - Country:US
Practice Address - Phone:623-512-4326
Practice Address - Fax:623-594-2252
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2024-08-10
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Provider Licenses
StateLicense IDTaxonomies
AZ378472086S0129X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery