Provider Demographics
NPI:1306387915
Name:LAPP, LAUREN C (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:C
Last Name:LAPP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W FAIRBANKS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4777
Mailing Address - Country:US
Mailing Address - Phone:407-635-3024
Mailing Address - Fax:321-203-4326
Practice Address - Street 1:1111 W FAIRBANKS AVE STE 200
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4777
Practice Address - Country:US
Practice Address - Phone:407-635-3024
Practice Address - Fax:321-203-4326
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110249363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020938800Medicaid