MEDICARE: JENNIFER LOMBARDO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW14312	FL

General Provider Information

NPI Number	:	1265967640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER LOMBARDO LLC

Provider Business Mailing Address
First Line	:	1309 E ROBINSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1309 E ROBINSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2117
Country	:	US
Telephone Number	:	407-455-2926
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	JENNIFER LOMBARDO
Credential	:	LCSW
Telephone Number	:	407-455-2926

Provider Enumeration Date	:	04/24/2017
Last Update Date	:	04/24/2017

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