MEDICARE: NELIUDIS NAVARRO LORES APRN-FNP

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	363LP2300X	Primary Care Nurse Practitioner	11004067	FL
2	363LF0000X	Family Nurse Practitioner	F358338-01	NY

General Provider Information

NPI Number	:	1518509975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NELIUDIS NAVARRO LORES APRN-FNP

Provider Business Mailing Address
First Line	:	1814 SW 23RD CT
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-3036
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1814 SW 23RD CT
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991
Country	:	US
Telephone Number	:	786-294-4527
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2019
Last Update Date	:	06/08/2026

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