MEDICARE: VALERIE ANN GORA LMT

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	171W00000X	Contractor	MA 49976	FL

General Provider Information

NPI Number	:	1619148228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE ANN GORA LMT

Provider Business Mailing Address
First Line	:	745 US HIGHWAY 1
Second Line	:	SUITE 102
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4409
Country	:	US
Telephone Number	:	561-283-3404
Fax Number	:

Provider Business Practice Location Address
First Line	:	745 US HIGHWAY 1
Second Line	:	SUITE 102
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4409
Country	:	US
Telephone Number	:	561-283-3404
Fax Number	:

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

Provider Enumeration Date	:	03/22/2008
Last Update Date	:	06/16/2010

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