Healthcare Provider Details

I. General information

NPI: 1326065400
Provider Name (Legal Business Name): LAMIA LALOUI P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 05/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 581
ORLANDO FL
32804-4647
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 581
ORLANDO FL
32804-4647
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2070
  • Fax:
Mailing address:
  • Phone: 407-303-2070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA052548
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA052548
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00418
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9108059
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: