Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 180291 | UT |
NPI | 1073729943 |
---|---|
Provider Name | Dr. Lauren Opal Florence |
First Address | Salt Lake City, UT 84124-1362 |
Second Address | Salt Lake City, UT 84124-1362 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 16/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180291 | PHYSICIAN AND SURGEON (01) | UT |