Organization
ISLAND WEIGHT LOSS
Active
Parent organization
ISLAND WEIGHT LOSS
Organization subpart
Yes
Provider details
NPI number
Legal business name
ISLAND WEIGHT LOSS
Authorized official
MS. PATRICIA JANE LAURIA (PRESIDENT)
(321) 453-2410
Entity
Organization
Contact information
Practice address
1365 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4405
(321) 453-2410
Mailing address
1365 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4405
(321) 453-2410
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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