Healthcare Provider Details

I. General information

NPI: 1942638507
Provider Name (Legal Business Name): LORRIE EMIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

8637 ACOMA DR
ORLANDO FL
32829-8507
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-9225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN9201860
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: