Healthcare Provider Details

I. General information

NPI: 1942977913
Provider Name (Legal Business Name): LORI WOODY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5797-A NW 151 STREET
MIAMI LAKES FL
33014
US

IV. Provider business mailing address

PO BOX 173085
MIAMI FL
33017-3085
US

V. Phone/Fax

Practice location:
  • Phone: 305-826-5674
  • Fax: 305-826-1102
Mailing address:
  • Phone: 305-826-5674
  • Fax: 305-826-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIA LOURDES WOODY
Title or Position: CEO
Credential: RN, BSN, CCM, CDMS,
Phone: 305-826-5674