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Individual

DR. LAURENTINA P KOCIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
801 S DOUGLAS RD, PEMBROKE PINES, FL 33025-1355
(954) 985-1470
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
ME28084
FL
208000000X
Pediatrics Physician
Primary
ME28084
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
92836
BLUE SHIELD
FL
Enumeration date
06/17/2006
Last updated
07/23/2007
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