Individual
MS. LAURA ELIZABETH GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1511 SW 1ST AVE, OCALA, FL 34471-6505
(352) 867-8311
(352) 867-1053
Mailing address
PO BOX 3130, OCALA, FL 34478-3130
(352) 867-8311
(352) 867-1053
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9104085
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292688100
—
FL
Enumeration date
02/08/2007
Last updated
04/16/2009
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