Active NPI
Joel Laurenceau
- Contractor
- Port Saint Lucie, FL
National Provider Identifier
1477151884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 2561 SW Grotto Cir
Port Saint Lucie, FL 34953-2927 - Phone
- (786) 333-7288
- NPI assigned
- Oct 16, 2020
- Last updated
- Oct 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
2561 SW Grotto Cir
Port Saint Lucie, FL 34953-2927
Mailing address
2561 SW Grotto Cir
Port Saint Lucie, FL 34953-2927
Phone (786) 333-7288
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L652-425-70-173-0 | Other | FL | DRIVER LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1477151884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2561 SW GROTTO CIR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349532927",
"telephone_number": "786-333-7288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2561 SW GROTTO CIR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349532927",
"telephone_number": "786-333-7288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAURENCEAU",
"first_name": "JOEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-16",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE",
"identifier": "L652-425-70-173-0",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.