Provider Demographics
NPI:1366312225
Name:ORELLANO LAUREANO, ELSIE AIMEE (PHD, RDN, LMT)
Entity type:Individual
Prefix:
First Name:ELSIE
Middle Name:AIMEE
Last Name:ORELLANO LAUREANO
Suffix:
Gender:F
Credentials:PHD, RDN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 WHITNEY PL
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-4161
Mailing Address - Country:US
Mailing Address - Phone:813-798-0800
Mailing Address - Fax:
Practice Address - Street 1:2109 WHITNEY PL
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-4161
Practice Address - Country:US
Practice Address - Phone:813-798-0800
Practice Address - Fax:813-798-7800
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2024133V00000X
FLMA101474225700000X
FLND11499133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist