Provider Demographics
NPI:1770770745
Name:DR. LAURA FIORENZA, O.D. LLC
Entity type:Organization
Organization Name:DR. LAURA FIORENZA, O.D. LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FIORENZA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-489-3937
Mailing Address - Street 1:11304 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-2313
Mailing Address - Country:US
Mailing Address - Phone:513-489-3937
Mailing Address - Fax:513-489-3936
Practice Address - Street 1:11304 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2313
Practice Address - Country:US
Practice Address - Phone:513-489-3937
Practice Address - Fax:513-489-3936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4740152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU64697Medicare UPIN
OH6234270001Medicare NSC