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NPI Code Detail

MEDICARE: MRS. LORETTA GEORGIOU

MEDICARE: MRS. LORETTA GEORGIOU
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
1106H00000XMarriage & Family TherapistIMT 2255FL

General Provider Information

NPI Number : 1518338219
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORETTA GEORGIOU
Provider Business Mailing Address
First Line : 2430 ESTANCIA BLVD STE 106
Second Line :
City : CLEARWATER
State : FL
Zip : 33761-2607
Country : US
Telephone Number : 727-460-6649
Fax Number :
Provider Business Practice Location Address
First Line : 2430 ESTANCIA BLVD STE 106
Second Line :
City : CLEARWATER
State : FL
Zip : 33761-2607
Country : US
Telephone Number : 727-460-6649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2015
Last Update Date : 11/05/2021

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Directions to “ MRS. LORETTA GEORGIOU ” Practice Location

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