Healthcare Provider Details

I. General information

NPI: 1275140105
Provider Name (Legal Business Name): LORIN EORI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 66TH ST N
PINELLAS PARK FL
33781-3102
US

IV. Provider business mailing address

11805 ACORN WOODS TER
LAKEWOOD RANCH FL
34202-2803
US

V. Phone/Fax

Practice location:
  • Phone: 727-202-3120
  • Fax:
Mailing address:
  • Phone: 724-875-9361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS60649
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: