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Individual

DR. LAURA R PAULK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12920 SUGARBLUFF RD, CLERMONT, FL 34715-6834
(407) 810-3148
Mailing address
12920 SUGARBLUFF RD, CLERMONT, FL 34715-6834
(407) 810-3148

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME76046
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254231500
FL
Enumeration date
09/27/2005
Last updated
01/25/2012
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