Healthcare Provider Details

I. General information

NPI: 1275602252
Provider Name (Legal Business Name): LORIE ANNE SABLAD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LORIE ANNE DAUGHERTY ARNP

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 MILAN DR ORLANDO
ORLANDO FL
32810-4405
US

IV. Provider business mailing address

4726 ALEXIS DR
KISSIMMEE FL
34746-5964
US

V. Phone/Fax

Practice location:
  • Phone: 407-296-6430
  • Fax:
Mailing address:
  • Phone: 321-677-3612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number9246653
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: