Individual
LAUREN MARIE CANARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
515 CARLTON STREET, PIONEER MEDICAL CENTER, WAUCHULA, FL 33873
(863) 773-6606
(863) 773-9542
Mailing address
515 CARLTON STREET, WAUCHULA, FL 33873
(863) 773-6606
(863) 773-9542
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101695
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291389500
—
FL
05
—
PA9101695
—
FL
Enumeration date
08/31/2006
Last updated
08/28/2013
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