Provider Demographics
NPI:1124579255
Name:MCINTOSH, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MCINTOSH
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 1:974 PIEDMONT OAKS DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-3415
Mailing Address - Country:US
Mailing Address - Phone:352-227-0548
Mailing Address - Fax:
Practice Address - Street 1:974 PIEDMONT OAKS DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-3415
Practice Address - Country:US
Practice Address - Phone:352-227-0548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health