Individual
LAURIE ANN TRUOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5776 SAINT AUGUSTINE RD, JACKSONVILLE, FL 32207-8030
(904) 448-4700
Mailing address
13853 HILLANDALE DR, JACKSONVILLE, FL 32225-1901
(904) 333-2854
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME0103475
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000824000
—
FL
05
—
122022700
—
FL
01
—
2019001329
MO MEDICAL LICENSE
MO
Enumeration date
05/21/2007
Last updated
05/13/2024
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