Individual
LAURA VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1890 LEMON AVE, KISSIMMEE, FL 34746-3710
(407) 452-0254
Mailing address
6884 MOORHEN CIR, ORLANDO, FL 32810-6075
(407) 375-0423
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10936
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000378300
—
FL
Enumeration date
05/29/2015
Last updated
05/29/2015
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