Provider Demographics
NPI:1306661343
Name:QUEIROZ, LAURA FISCHER (DH)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:FISCHER
Last Name:QUEIROZ
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 BRIGHT IBIS AVE
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3548
Mailing Address - Country:US
Mailing Address - Phone:656-999-1880
Mailing Address - Fax:
Practice Address - Street 1:123 BRIGHT IBIS AVE
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-3548
Practice Address - Country:US
Practice Address - Phone:656-213-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist