Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | A169271 | CA |
Y | 207NP0225X | Pediatric Dermatologist | A169271 | CA |
NPI | 1033572391 |
---|---|
Provider Name | Dr. Lauren Marie Metterle |
First Address | Clearwater, FL 33756-3460 |
Second Address | Clearwater, FL 33756-3460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2016 |
Last Update Date | 30/12/2021 |