| Dr. Elisa Laconich, Ph.d., Pllc | |
|
12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 | |
| (904) 374-4276 | |
| Not Available |
| Full Name | Dr. Elisa Laconich, Ph.d., Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 12574 Flagler Center Blvd Ste 101, Jacksonville, Florida |
| Authorized Official Name and Position | Alicia Elisa Ayala Laconich (CLINICAL NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 5615773402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Elisa Laconich, Ph.d., Pllc 12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 Ph: () - | Dr. Elisa Laconich, Ph.d., Pllc 12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 Ph: (904) 374-4276 |
| NPI Number | 1598341307 |
|---|---|
| Provider Enumeration Date | 03/22/2021 |
| Last Update Date | 03/22/2022 |
| Certification Date | 03/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598341307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
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