Provider Demographics
NPI:1528356326
Name:MARANO RUSH, LAURA ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ELIZABETH
Last Name:MARANO RUSH
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:8926 77TH TER E
Mailing Address - Street 2:UNIT 101
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-6417
Mailing Address - Country:US
Mailing Address - Phone:941-907-0222
Mailing Address - Fax:941-907-0493
Practice Address - Street 1:8926 77TH TER E
Practice Address - Street 2:UNIT 101
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-6417
Practice Address - Country:US
Practice Address - Phone:941-907-0222
Practice Address - Fax:941-907-0493
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2024-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9106039363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFH579ZMedicare PIN