1538158423 NPI number — LAURA T. CLOUKEY M.D.

Table of content: MAYESHA AHMED DO (NPI 1043172554)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538158423 NPI number — LAURA T. CLOUKEY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLOUKEY
Provider First Name:
LAURA
Provider Middle Name:
T.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538158423
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1020 LAKE SUMTER LNDG
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THE VILLAGES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32162-2699
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-674-1720
Provider Business Mailing Address Fax Number:
352-674-8919

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2485 PINELLAS PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THE VILLAGES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32163-2703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-674-1720
Provider Business Practice Location Address Fax Number:
352-674-8920
Provider Enumeration Date:
10/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  OS12801 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 473570 . This is a "AETNA/US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3122271 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0001190 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 079309 . This is a "TUFTS ASSOCIATED HEALTH P" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64359 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: B10159801 . This is a "CIGNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000020218 . This is a "BOSTON HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110231259 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: J30429 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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