Provider Demographics
NPI:1902896624
Name:KAYALEH, LAURI J (MD)
Entity type:Individual
Prefix:DR
First Name:LAURI
Middle Name:J
Last Name:KAYALEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7051 DR PHILLIPS BLVD SUITE 7
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5140
Mailing Address - Country:US
Mailing Address - Phone:407-345-9929
Mailing Address - Fax:407-447-8969
Practice Address - Street 1:7051 DR PHILLIPS BLVD SUITE 7
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5140
Practice Address - Country:US
Practice Address - Phone:407-345-9929
Practice Address - Fax:407-447-8969
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2024-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME72510208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01479Medicare UPIN