Provider Demographics
NPI:1699055145
Name:DEMERS, LAURA K (PT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:K
Last Name:DEMERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9931 SW 195TH ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8661
Mailing Address - Country:US
Mailing Address - Phone:305-505-9242
Mailing Address - Fax:305-232-3028
Practice Address - Street 1:9931 SW 195TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8661
Practice Address - Country:US
Practice Address - Phone:305-505-9242
Practice Address - Fax:305-232-3028
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 24905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist