Provider Demographics
NPI:1265301105
Name:GONZALEZ PEREZ, LADY LAURA
Entity type:Individual
Prefix:
First Name:LADY
Middle Name:LAURA
Last Name:GONZALEZ PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3575 21ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-6617
Mailing Address - Country:US
Mailing Address - Phone:239-405-2828
Mailing Address - Fax:
Practice Address - Street 1:3575 21ST AVE SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34117-6617
Practice Address - Country:US
Practice Address - Phone:239-405-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program