Provider Demographics
NPI:1487090569
Name:CHAMORRO DAUER, LAURA VICTORIA (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:VICTORIA
Last Name:CHAMORRO DAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:VICTORIA
Other - Last Name:CHAMORRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2000 NORTH BAYSHORE DRIVE
Mailing Address - Street 2:APT. 1405
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137
Mailing Address - Country:US
Mailing Address - Phone:954-684-7451
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:786-466-8381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2017-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128053208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics