Provider Demographics
NPI:1962122143
Name:TREMBLAY, LAUREN ELIZABETH (DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S 5TH ST STE 100D
Mailing Address - Street 2:
Mailing Address - City:IMMOKALEE
Mailing Address - State:FL
Mailing Address - Zip Code:34142-4301
Mailing Address - Country:US
Mailing Address - Phone:239-517-9015
Mailing Address - Fax:949-404-8793
Practice Address - Street 1:750 S 5TH ST STE 100D
Practice Address - Street 2:
Practice Address - City:IMMOKALEE
Practice Address - State:FL
Practice Address - Zip Code:34142-4301
Practice Address - Country:US
Practice Address - Phone:239-517-9015
Practice Address - Fax:949-404-8793
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1340458225100000X
FL36656225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist