Healthcare Provider Details

I. General information

NPI: 1326272733
Provider Name (Legal Business Name): ANNE LORD DO, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12650 WORLD PLAZA LN BLDG 72 SUITE 2
FORT MYERS FL
33907-3987
US

IV. Provider business mailing address

12650 WORLD PLAZA LN BLDG 72-2
FORT MYERS FL
33907-4077
US

V. Phone/Fax

Practice location:
  • Phone: 239-656-9006
  • Fax: 239-372-0269
Mailing address:
  • Phone: 239-656-9006
  • Fax: 239-236-1595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS9878
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberOS9883
License Number StateFL

VIII. Authorized Official

Name: DR. ANNE M LORD
Title or Position: OWNER
Credential: DO
Phone: 239-656-9006