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Contact Information

LAURA E DERMENJIAN, PA
1950 LAUREL MANOR DR
STE 224
THE VILLAGES, FL32162
 Phone: 352-751-6565
 Fax: 352-205-7777
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LAURA E DERMENJIAN · (Female)

NPI # 1255316907
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 12/14/2005
Last updated 08/18/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PA9101262
  • FL Medicaid 290911100
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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