Provider Demographics
NPI:1851545610
Name:PAGE, LAUREN GRECO (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:GRECO
Last Name:PAGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MARIE
Other - Last Name:GRECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 23329
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-3329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:410-883-0876
Practice Address - Street 1:6331 MEMORIAL HWY STE D
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4537
Practice Address - Country:US
Practice Address - Phone:813-882-9986
Practice Address - Fax:813-882-9849
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9119748363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant