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Individual

LYDIA MARIE LASER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, APRN, CRNA

Contact information

Practice address
3625 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4207
(904) 702-6111
Mailing address
4713 FRENCH ST, JACKSONVILLE, FL 32205-5001
(860) 227-2004

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9443824
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
11037321
FL

Other

Enumeration date
01/07/2025
Last updated
01/28/2025
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