Healthcare Provider Details

I. General information

NPI: 1811825946
Provider Name (Legal Business Name): LORA SIERRA AP, DOM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12670 NEW BRITTANY BLVD STE 204
FORT MYERS FL
33907-3650
US

IV. Provider business mailing address

1517 SE 17TH TER
CAPE CORAL FL
33990-4597
US

V. Phone/Fax

Practice location:
  • Phone: 239-770-2492
  • Fax:
Mailing address:
  • Phone: 239-770-2492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4736
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: