Individual
LAUREN MARIE RICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
305 MEMORIAL MEDICAL PKWY, SUITE 205, DAYTONA BEACH, FL 32117
(386) 231-3530
(386) 231-3534
Mailing address
305 MEMORIAL MEDICAL PKWY, SUITE 205, DAYTONA BEACH, FL 32117-5168
(386) 231-3530
(386) 231-3534
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9106176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FS455Z
MEDICARE
FL
Enumeration date
10/17/2011
Last updated
07/18/2018
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